Notice of Privacy Practices

RxAdvance collects various privacy data to conduct business. Categories of such privacy data are member data, provider pharmacy data, employee/contractor data and data collected through the website. Additionally, miscellaneous privacy data may be collected, and it would fall into “other” category of privacy data.

RxAdvance informs members of how their Personal Health Information/Individually Identifiable Health Information (“PHI/IIHI”) is used and disclosed, how the member may request disclosure of their PHI/IIHI and how they may limit the disclosure of PHI/IIHI.  Additionally, RxAdvance informs provider pharmacies, employees/contractors and website visitors of how their privacy data is used and disclosed.

To ensure that RxAdvance has a proper and sufficient process for notice of Privacy Practices to relevant parties. RxAdvance will provide a Notice of Privacy Practices upon request to a relevant party. Please submit request to RxAdvance Attn: Privacy Officer 136 Turnpike Road Southborough, MA 01772

Notice of Privacy Practices to the member

RxAdvance Notice of Privacy Practices to the member will contain the following information:

• Use and disclosures of PHI/IIHI without authorization of the member for the purposes of:
• Payment, treatment or health care operations, including evaluation activities. A description of all other purposes for which RxAdvance is permitted or required to use or disclose PHI/IIHI without the individual’s written authorization.
• A statement of the member’s rights with respect to PHI/IIHI.
• If a use or disclosure for any purpose is prohibited or significantly limited by another applicable law, the description of such use or disclosure shall reflect the more stringent law.
• A statement of the use and disclosure of PHI/IIHI that requires the member’s authorization.
• A statement indicating that the sale and/or marketing of member privacy data for marketing purposes or to a third party is prohibited.
• A statement indicating that psychotherapy notes (to the extent available) is prohibited, unless a member’s authorization has been obtained.
• The right to inspect and obtain a copy of the member’s PHI/IIHI maintained by RxAdvance, some exceptions may apply.
• The right to request an amendment to the PHI/IIHI maintained by RxAdvance if the information is incomplete or incorrect.
• The right to request additional restriction on the use and disclosure of a member’s PHI/IIHI.
• The right to request an accounting of disclosures made by RxAdvance for purposes other than treatment, payment or health care operations. Some disclosures need not be included in the accounting that RxAdvance provides to a member.
• The right to receive information about the handling of his or her PHI/IIHI.
• The right to request confidential communications regarding his or her PHI/IIHI.
• A statement indicating that, if a member contacts the RxAdvance Consumer Services Department, appropriate validation will be performed.
• A statement indicating that the member may be contacted for the purpose of providing refill reminders or other healthcare follow-up and education, where applicable.
• A statement describing how to obtain a paper copy of the Notice at any time, free of charge. The right to file a complaint, including address and telephone information to file a complaint, if the member feels his or her rights have been violated by RxAdvance.
• The right to be notified in the event that there is a breach of a member’s unsecured PHI/IIHI, as defined by HIPAA.
• Contact information for RxAdvance Privacy Officer.

Notice of Privacy Practices to a Pharmacy Provider

For Notices of Privacy Practices involving member data, such as PHI, please refer to Notice of Privacy Practices to a member section above.

RxAdvance Notice of Privacy Practices to a pharmacy provider may contain the following information:

• Use and disclosure of provider data including, but not limited to, NPI, provider name, and provider contact information.
• Use and disclosure of information gathered and verified over the phone including, but not limited to, member PHI, claims information, and prescriptions.
  • Should the pharmacy require contacting the RxAdvance Consumer Services Department, appropriate validation will be performed.
• If a use or disclosure for any purpose is prohibited or significantly limited by another applicable law, the description of such use or disclosure shall reflect the more stringent law.
• A statement of the pharmacy’s rights with respect to confidential and private pharmacy provider information.
• A statement indicating confidential pharmacy provider information obtained during the credentialing process will not be disclosed to third parties without the provider’s authorization unless otherwise permitted, or otherwise contractually required or required by law.
• A description of privacy data collection for the purpose of use of RxAdvance’s platform or pharmacy provider portal.
  • A description of privacy data collection regarding submitted data on the pharmacy provider portal for MAC appeals.
• A statement indicating that sale and/or marketing of pharmacy provider data is prohibited.

Notice of Privacy Practices to a Prescriber

RxAdvance Notice of Privacy Practices to a prescriber may contain the following information:

• Use and disclosure of prescriber data including, but not limited to, NPI, prescriber name, and prescriber contact information, license numbers, data collected during the Prior Authorization.
• Use and disclosure of information gathered and verified over the phone including, but not limited to, member PHI, claims information, and prescriptions.
  • Should the prescriber require contacting the RxAdvance Consumer Services Department, appropriate validation will be performed.
• If a use or disclosure for any purpose is prohibited or significantly limited by another applicable law, the description of such use or disclosure shall reflect the more stringent law.
• A statement indicating that sale and/or marketing of prescriber data is prohibited.

Notice of Privacy Practices to an Employee/Contractor

RxAdvance Notice of Privacy Practices to an employee/contractor may contain the following information:

• Use and disclosure of general employee information and related data including, but not limited to, job application, resume, background check, contact information, benefit and payroll verification, and training records.
• Use and disclosure of privacy data collected while an employee is telecommuting/working from home including, but not limited to, IP address, network keys, phone number, VPN access, and Remote Desktop access.
• If a use or disclosure for any purpose is prohibited or significantly limited by another applicable law, the description of such use or disclosure shall reflect the more stringent law. A statement indicating that sale and/or marketing of employee/contractor privacy data is prohibited.

Notice of Privacy Practices Regarding Website Data Collection

RxAdvance Notice of Privacy Practices regarding website data collection may contain the following information:

• Use and possible collection of data through RxAdvance’s website including, but not limited to, IP address, geographic location, and information submitted through online forms such as name, email address, contact information, and questions.
• A statement indicating use of cookies for tracking visits and activity.
• A statement indicating the use and intent of third-party websites.
• A statement indicating that sale and/or marketing of collected website data is prohibited.
• If a use or disclosure for any purpose is prohibited or significantly limited by another applicable law, the description of such use or disclosure shall reflect the more stringent law.