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Medical Emergency Ambulance, Inc.
THIS NOTICE DESCRIBES HOW MEDICAL
INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN
GET ACCESS TO THIS INFORMATION. PLEASE READ CAREFULLY.
DOWNLOAD FULL TEXT IN ADOBE ACROBAT FORMAT
HERE.
Medical Emergency Ambulance, Inc. is required
by law to maintain the privacy of certain confidential health
care information, known as Protected Health Information or PHI,
and to provide you with a notice of our legal duties and privacy
practices with respect to your PHI. Medical Emergency is
also required to abide by the terms of the version of this
Notice currently in effect.
Uses and Disclosures of PHI:
Medical Emergency Ambulance may use PHI for the purposes of
treatment, payment, and health care operations, in most cases
without your written permission. Examples of our use of
your PHI:
For Treatment:
This includes such things as obtaining verbal and written
information about your medical condition and treatment from you
as well as from others, such as doctors and nurses who give
orders to allow us to provide treatment to you. We may
give your PHI to other health care providers involved in your
treatment, and may transfer your PHI via radio or telephone to
the hospital or dispatch center.
For payment:
This includes any activities we must undertake in order
to get reimbursed for the services we provide to you, including
such things as submitting bills to insurance companies, making
medical necessity determinations and collecting outstanding
accounts.
For HealthCare
Operations: This includes quality assurance activities,
licensing, and training programs to ensure that our personnel
meet our standards of care and follow established policies and
procedures, as well a certain other management functions.
Reminders for
Scheduled Transports and Information on Other Services:
We may also contact you to provide you with a reminder of any
scheduled appointments for non-emergency ambulance and medical
transportation, or provide information about other services we
provide.
Use and Disclosure of PHI Without
Your Authorization: Medical Emergency Ambulance is
permitted to use PHI without your written authorization, or
opportunity to object, in certain situations, and unless
prohibited by a more stringent state law, including:
- For treatment, payment of health care
operations activities of another health care provider who
treats you;
- For health care and legal compliance
activities;
- To a family member, other relative, or
close personal friend or other individual involved in your
care if we obtain your verbal agreement to do so or if we
give you an opportunity to object to such a disclosure and
you do not raise and objection, and in certain other
circumstances where we are unable to obtain your agreement
and believe the disclosure is in your best interests;
- To a public health authority in certain
situations as required by law (such as to report abuse,
neglect or domestic violence);
- For health oversight activities including
audits or government investigations, inspections,
disciplinary proceedings, and other administrative or
judicial actions undertaken by the government (or their
contractors) by law to oversee the health care system;
- For judicial and administrative
proceedings as required by a court or administrative order
or in some cases in response to a subpoena or other legal
process;
- For law enforcement activities in limited
situation, such as when responding to a warrant;
- For military, national defense and
security and other special government functions;
- To avert a serious threat to the health
and safety of a person or the public at large;
- For workers' compensation purposes, and
in compliance with workers' compensation laws;
- To coroners, medical examiners, and
funeral directors for identifying a deceased person,
determining cause of death, or carrying on their duties as
authorized by law;
- If you are an organ donor, we may release
health information to organizations that handle organ
procurement or organ, eye or tissue transplantation;
- For research projects, but this will be
subject to strict oversight and approvals;
- We may also use or disclose health
information about you in a way that does not personally
identify you or reveal who you are.
Any other use or disclosure of PHI, other than
those listed above will only be made with your written
authorization. You may revoke your authorization at any
time, in writing, except to the extent that we have already used
or disclosed medical information in reliance on that
authorization.
Patient Rights: As a
patient, you have a number of rights with respect to your PHI,
including:
The right to
access, copy or inspect your PHI. This means you may
inspect and copy most of the medical information about you that
we maintain. We will normally provide you with access to
this information within 30 days of your request. We may
also charge you a reasonable fee for you to copy and
medical information that you have the right to access. In
limited circumstance, we may deny you access to your medical
information, and you may appeal certain types of denials.
We have available forms to request access to your PHI and we
will provide a written response if we deny you access and let
you know your appeal rights. You also have the right to
receive, confidential communications of your PHI. If you
wish to inspect and copy your medical information, you should
contact our Privacy Officer.
The right to
amend your PHI. You have the right to ask us to amend
written medical information that we may have about you. We
will generally amend your information within 60 days of your
request and will notify you when we have amended the
information. We are permitted by law to deny your request
to amend your medical information only in certain circumstance,
like when we believe the information you have asked us to amend
is correct. If you wish to request that we amend the
medical information that we have about you, you should contact
our privacy officer.
The right to
request that we restrict the uses and disclosures of your PHI.
You have the right to request that we restrict how we use and
disclose your medical information that we have about you.
Medical Emergency Ambulance is not required to agree to any
restrictions you request, but any restrictions agreed to by
Medical Emergency Ambulance in writing are binding on Medical
Emergency Ambulance.
Internet, Electronic Mail, and the Right
to Obtain Copy of Paper Notice on Request. If we
maintain a web site, we will prominently post a copy of this
Notice on our web site. If you allow us, we will forward
you this Notice by electronic mail instead of on paper and you
may always request a paper copy of the Notice.
Revision to the Notice: Medical
Emergency Ambulance reserves the right to change the terms of
this Notice at any time, and the changes will be effective
immediately and will apply to all protected health information
that we maintain. Any material changes to the Notice will
be promptly posted in our facilities and posted to our web site,
if we maintain one. You can get a copy of the latest
version of this Notice by contacting our Privacy Officer.
Your Legal Rights and Complaints:
You also have the right to complain to us, or to the Secretary
of the United States Department of Health and Human Services if
you believe your privacy rights have been violated. You
will not be retaliated against in any way for filing a complaint
with us or to the government. Should you have any
questions, comments or complaints, you may direct all inquiries
to our Privacy Officer:
Privacy Officer
Medical Emergency Ambulance, Inc.
PO Box 1427
Skyland, NC 28776
828-684-0287
828-684-6274 (fax)
Effective Date of this Notice: April 14, 2003
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