PITTSTON TOWNSHIP

AMBULANCE

ASSOCIATION


Our 40th Anniversary Year

1977 - 2017


THIS HIPPA POLICY IS REQUIRED TO BE ON OUR WEB SITE FOR PUBLIC VIEWING. 

IF YOU HAVE ANY QUESTIONS REGARDING THIS POLICY, PLEASE CONTACT OUR AGENCY AT THE ADDRESS LISTED.

                                          Pittston Township Ambulance Association

Notice of Privacy Practice
 
IMPORTANT: THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

As an essential part of our commitment to you, Pittston Twp. Ambulance Association  maintains the privacy of certain confidential health care information about you, known as Protected Health Information or PHI. We are required by law to protect your health care information and to provide you with the attached Notice of Privacy Practices.

The Notice outlines our legal duties and privacy practices respect to your PHI.  It not only describes our privacy practices and your legal rights, but lets you know, among other things, how the Pittston Twp. Ambulance Association is permitted to use and disclose PHI about you, how you can access and copy that information, how you may request amendment of that information, and how you may request restrictions on our use and disclosure of your PHI.

Pittston Twp. Ambulance Association is also required to abide by the terms of the version of this Notice currently in effect. In most situations we may use this information as described in this Notice without your permission, but there are some situations where we may use it only after we obtain your written authorization, if we are required by law to do so.

We respect your privacy and treat all health care information about our patients with  care under strict policies of confidentiality that all of our staff are committed to following at all times.

Please read the following detailed notice. If you have any questions about it, please contact our Privacy Officer, at (570) 654-4717

 THIS     NOTICE     DESCRIBES      HOW      MEDICAL INFORMATION   ABOUT   YOU   MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Purpose of this Notice:   Pittston Twp. Ambulance Association 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. This Notice describes your legal rights, advises you of our privacy practices and lets you know how Pittston Twp. Ambulance Association is permitted to use and disclose PHI about you.

 Pittston Twp. Ambulance Association is also required to abide by the terms of the version of this Notice currently in effect. In most situations we may use this information as described in this Notice without your permission, but there are some situations where we may use it only after we obtain your written authorization, if we are required by law to do so.

 Uses     and    Disclosures     of    PHI:   Pittston   Twp.   Ambulance Association 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 verbal and written information that we obtain about you and use pertaining to your medical condition and treatment provided to you by us and other medical   personnel   (including   doctors   and nurses who   give orders to allow us to  provide treatment  to you).  It also includes information we  give to other  health care personnel to whom we transfer  your  care  and  treatment,  and  includes  transfer  of  PHI via  radio or telephone  to the  hospital or dispatch center  as well as  providing  the  hospital  with  a  copy  of  the  written  record  we create   in  the   course   of   providing   you   with   treatment   and transport.

 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 organizing your  PHI and submitting bills to  insurance  companies  (either  directly  or  through  a third  party billing  company),   management   of   billed  claims   for   services rendered,    medical   necessity    determinations    and    reviews, utilization review, and collection of outstanding accounts.

 For health care 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,  obtaining  legal and financial  services, conducting   business   planning,   processing   grievances   and complaints,  creating reports that do not individually  identify you for data  collection  purposes, fundraising, and. certain  marketing activities.

 Fundraising.   We may contact you when we are in the process of raising funds for Pittston Twp. Ambulance Association, or to provide you with information about   our   annual   subscription program.

 Information on Other Services. We may also contact you to provide you with information about alternative services we provide or other health-related benefits and services that may be of interest to you.

 Use and Disclosure of PHI Without Your Authorization.   Pittston Twp.  Ambulance  Association  is  permitted  to  use  PHI  without your  written  authorization,  or  opportunity  to  object  in  certain situations, including:

For Pittston Twp. Ambulance Association's use in treating you or in obtaining payment for services provided to you or in other health care operations;

For the treatment activities of another health care provider;

To another health care provider or entity for the payment activities of the provider or entity that receives the information (such as your hospital or insurance company);

To another health care provider (such as the  hospital to which you are transported) for the health care operations activities of the entity that receives the  information  as  long as the entity receiving the information has or has had a relationship with you and the PHI pertains to that  relationship;

For health care fraud and abuse detection or for activities related to compliance with the law;

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  an  objection. We   may   also   disclose   health   information   to   your   family, relatives, or friends if we infer from the circumstances that you would not object.  For example, we may assume you agree to our   disclosure   of   your   personal health   information   to your spouse when your spouse has called the ambulance for you.   In situations where  you are not capable of objecting   (because you are   not   present   or   due   to   your    incapacity    or    medical· emergency),  we  may,  in our  professional  judgment,  determine that  a disclosure  to your family  member,  relative, or friend  is in your  best interest. In that  situation, we  will disclose  only  health information  relevant  to  that  person's  involvement  in your  care. For example, we  may inform the  person who  accompanied  you in the  ambulance  that  you have certain symptoms  and we  may give that person an update on your vital signs and treatment that is being administered by our ambulance crew;

To a public health authority in certain situations  (such as reporting a birth, death or disease as required by law, as part of  a public health investigation, to report child or adult abuse or neglect  or domestic  violence, to report adverse  events  such  as product  defects,  or  to  notify  a  person  about  exposure  to  a possible communicable disease as required by law;

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  situations , such  as  when  there  is  a  warrant  for  the  request, or when  the information is needed to locate a suspect or stop a crime;

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 or to an organ donation  bank, as  necessary  to facilitate organ donation and transplantation ;

For research projects, but this will  be subject to strict oversight and approvals and health information will be released only when there is a minimal risk to your privacy and adequate safeguards are in place in accordance with the  law;

We  may  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 (the authorization must specifically identify the information we seek to use or disclose, as well as when and how we seek to use or disclose it). 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 the protection of your   PHI, including:

The right to access, copy or inspect your PHI.  This means you  may come to our offices  and 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 any medical information that you have the right to access.   In limited circumstances, 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.   If you wish to    inspect    and    copy    your    medical information you should contact the privacy officer listed at the end of this Notice.

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 circumstances,  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  the privacy officer  listed at the end of this Notice.

The right to request an accounting of our use and disclosure of your PHI. You may request an accounting from us of certain disclosures of your medical information that we have made in the last six years prior to the date of your request. We are not required to  give  you an accounting  of information we   have   used   or  disclosed   for   purposes   of   treatment, payment  or  health care  operations,  or  when we  share  your health   information   with  our   business   associates,   like  our billing  company  or  a  medical facility  from/to  which  we  have transported you.

We  are  also  not  required  to  give you  an  accounting  of  our uses   of   protected   health   information   for   which  you   have already given  us written  authorization.  If you wish  to request an accounting  of  the  medical  information  about  you  that  we have   used   or   disclosed   that   is   not   exempted   from   the accounting   requirement,   you   should   contact   the   privacy officer listed at the end of this Notice.

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  for  treatment,  payment or  health  care  operations, or to  restrict the information that is  provided to family,  friends and other  individuals  involved in your health care.   But if you request  a  restriction  and  the  information  you  asked  us  to restrict  is  needed  to  provide  you  with  emergency  treatment, then we may use the PHI or disclose the PHI to a health care provider  to  provide  you  with  emergency  treatment.    Pittston Twp. Ambulance Association  is  not  required  to  agree to  any restrictions  you   request,  but  any   restrictions  agreed  to  by Pittston   Twp. Ambulance  Association  are  binding on Pittston Twp. Ambulance  Association .

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  and make the  Notice available electronically through  the 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.

 Revisions to the Notice:  Pittston Twp.  Ambulance Association 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 the Privacy Officer identified below.

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  the privacy  officer  listed  at  the  end  of  this Notice.  Individuals will not be retaliated against for filing a complaint.

If you have any questions or if you wish to file a complaint or exercise any rights listed on this Notice, please contact -

 Alyssa Bolen

Pittston Twp. Ambulance Association

24 Bryden Street

Pittston Twp., PA 18640