1. Uses and Disclosures of Protected Health Information
You will be asked to sign a Notice of Privacy Practice
or similarly worded statement related to disclosure of Protected Health Information. We will make a good faith effort to obtain a
written acknowledgement that you received this Notice of Privacy Practices for Protected Health Information the first time we provide
services to you or as soon as reasonably practicable under the circumstances. Your protected health information may be used and disclosed
by New Richmond Fire and Emergency Medical Services (NRFEMS), our department staff, and others outside of our department that are
involved in your care and treatment for the purpose of providing health care services to you. Your protected health information may
also be used and disclosed to obtain payment for your health care bills.
Following are examples of the types of uses and disclosures
of your protected health care information that NRFEMS is permitted to make. These examples are not meant to be exhaustive, but to
describe the typical uses and disclosures that may be made by our department.
· Treatment: We will
use and disclose your protected health information to provide, coordinate or manage your health care and any related services. This
includes the coordination or management of your health care with a third party that may need access to your protected health information.
For example, your protected health information may be provided to another emergency medical services agency that becomes involved
in your care to ensure it has the necessary information to properly treat you. We will also disclose protected health information
to hospital staff and physicians who may be treating you.
· Payment: Your protected health information
will be used, as needed, to obtain payment for your health care services. This may include certain activities that your health insurance
plan may undertake before it approves or pays for the health care services we recommend for you such as: making a determination of
eligibility or coverage for insurance benefits, reviewing services provided to you for medical necessity and undertaking utilization
review activities.
· Healthcare Operations: We may use or disclose, as needed, your protected health
information in order to support the business activities of NREMS. These activities include, but are not limited to, quality assessment
activities, employee review activities, training of EMT students, licensing, and conducting or arranging for other business activities.
We will share your protected health information with third party “business associates” that perform various activities (e.g., billing
services) for the department. Whenever an arrangement between our department and a business associate involves the use of disclosure
of your protected health information, we will have a written contract that contains terms that will protect the privacy of your protected
health information.
Other Uses and Disclosures of Protected Health Information
Other uses and disclosures of your protected health information
will be made only with your written authorization, unless otherwise permitted or required by law as described below. You may revoke
this authorization at any time, in writing, except to the extent that NRFEMS has taken an action in reliance on the use or disclosure
indicated in the authorization.
Other Permitted and Required Uses and Disclosures
We may use and disclose your protected health information
in the following instances. You have the opportunity to agree or object to the use or disclosure of all or part of your protected
health information. If you are not present or able to agree or object to the use or disclosure of the protected health information,
then NRFEMS may, using professional judgment, determine whether the disclosure is in your best interest. In this case, only the protected
health information that is relevant to your health care will be disclosed.
· Others Involved In
Your Healthcare: Unless you object, we may disclose to a member of your family, a relative, a close friend or any other person you
identify, your protected health information that directly related to that person’s involvement in your healthcare. If you are unable
to agree or object to such a disclosure, we may disclose such information as necessary if we determine that it is in your best interest
based on our professional judgment. We may use or disclose protected health information to notify or assist in notifying a family
member, personal representative or any other person that is responsible for your care of your location, general condition, or death.
Finally, we may use or disclose your protected health information to an authorized public or private entity to assist in disaster
relief efforts and to coordinate uses and disclosures to family or other individuals involved in your health care.
· Emergencies:
We may use or disclose your protected health information in an emergency treatment situation. If this happens, NRFEMS shall try to
obtain your acknowledgement of our Privacy Practices as soon as reasonably practical after delivery of treatment. If NRFEMS is required
by law to treat you and NRFEMS has attempted to obtain your acknowledgement but is unable to do so, NRFEMS may still use or disclose
your protected health information for treatment, payment, and health care options.
· Communication
Barriers: We may use and disclose your protected health information if attempts to obtain an acknowledgement of our Privacy Practices
is made but impossible due to substantial communication barriers.
Other Permitted and Required Uses and Disclosures that may be made
without Your Consent, Authorization or Opportunity to Object
We may use or disclose your protected health information in the following
situations without your acknowledgement or authorization. These situations include:
2. Your Rights
The following is a statement of your rights with respect to your protected
health information and a brief description of how you may exercise these tights.
You have the right to inspect and copy your protected
health information. This means you may inspect and obtain a copy of protected health information about you that is contained in a
designated record set for as long as we maintain that protected health information. A “designated record set” contains medical and
billing records and any other records that NRFEMS uses for making decisions about you. Applicable fees for copies and administrative
research costs may be assessed.
Under federal law, however; you may not inspect or copy the following records: psychotherapy notes;
information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding: and protected
health information that is subject to law that prohibits access to protected health information. Depending on the circumstances, a
decision to deny access may be reviewable. In some circumstances, you may have a right to have this decision reviewed. Please contact
our privacy officer if you have questions about access to your medical record.
You have the right to request a restriction of your
protected health information. This means you may ask us not to use or disclose any part of your protected health information for the
purposes of treatment, payment or healthcare operations. You may also request that any part of your protected health information not
be disclosed to family members or friends who may be involved in your care or for notification purposes as described in the Notice
of Privacy Practices. Your request must state the specific restriction requested and to whom you want the restriction to apply
NRFEMS
is not required to agree to a restriction that you may request. If NRFEMS believes it is in your best interest to permit use and disclosure
of your protected health information, your protected health information will not be restricted. If NRFEMS does agree to the requested
restriction, we may not use or disclose your protected health information in violation of that restriction unless it is needed to
provide emergency treatment. With this in mind, please discuss any restriction you wish to request with NRFEMS. You may request a
restriction by submitting a written request to our privacy officer.
You have the right to request to receive confidential communications
from us by alternative means or at an alternative location. We will accommodate reasonable requests. We may also condition this accommodation
by asking you for information as to how payment will be handled or specification of an alternative address or other method of contact.
We will not request an explanation from you as to the basis for the request. Please make this request in writing to our privacy officer.
You
have the right to receive an accounting of certain disclosures we have made, if any, of your protected health information. This right
applies to disclosures for purposes other than treatment, payment or healthcare operations and valid authorizations of incidental
disclosures as described in this Notice of Privacy Practices. It excludes disclosures we may have made to you, to family members or
friends involved in your care, or for notification purposes. You have the right to receive specific information regarding these disclosures
that occurred after. You may request a shorter timeframe. The right to receive this information is subject to certain exceptions,
restrictions and limitations
You have the right to obtain a paper copy of this notice from us, upon request.
3. Complaints:
You
may complain to us or to the Secretary of Health and Human Services if you believe your privacy rights have been violated by us. You
may file a complaint with us by notifying our privacy officer of your complaint.
The privacy officer of NRFEMS is the Chief Mark Baird.
You may contact him at 513-553-2117 for further information about the complaint process.
This notice was published and becomes effective
on
