Glenn Heights Fire Department

Notice of Privacy Practices

 

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.

 

Purpose of this Notice:  GHFD 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 GHFD is permitted to use and disclose PHI about you.

 

GHFD is required to abide by the terms 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 are required by law to obtain your written authorization before we may use it.  We respect your privacy, and treat health care information about our patients with care and under strict policies of confidentiality that all of our staff are committed to following at all times. 

 

Uses and Disclosures of PHI: GHFD may have reason to use PHI for the purposes of treatment, payment and health care operations.  Examples of our use of your PHI:

 

For treatment.  This includes:

·       Verbal and written information that we obtain about you and use pertaining to your medical condition;

·       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);

·       Information we give to other health care personnel to whom we transfer your care and treatment;

·       Transfer of PHI via radio or telephone to the hospital, other healthcare providers or dispatch center;

·       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:

·       Organizing your PHI

·       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;

·       Collection of outstanding accounts. 

 

For health care operations.  This includes:

·       Quality assurance activities, licensing;

·       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;

·       Certain research activities. 

 

Use and Disclosure of PHI without Your Authorization.  GHFD is permitted in certain situations to use PHI without your written authorization and without giving you the opportunity to object, including:

· For our 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, such as your hospital or insurance company, for their payment activities;

· 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 PHI 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 PHI to your spouse when your spouse has called the ambulance for you.   In situations where you are not capable of objecting (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 PHI 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 paramedics;

· 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;

· 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 PHI to organizations that handle organ, eye or tissue  procurement or transplantation or to an organ donation bank, as necessary to facilitate organ donation and transplantation;

· For research projects, PHI will be released only when there is a minimal risk to your privacy and adequate safeguards, including oversight and approvals are in place in accordance with the law;

We may use or disclose PHI in a way that does not personally identify you or reveal who you are.

 

Other Use of PHI.  Any other use or disclosure of PHI, other than those listed above will only be made with your written authorization.  We will 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 PHI 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 forms available to request access to your PHI.  We will provide a written response if we deny you access and let you know your appeal rights.  To inspect and copy your medical information, contact the Privacy Officer identified below.

· You have 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, such as when we believe the information you have asked us to amend is correct.  To request that we amend the medical information that we have about you, contact the Privacy Officer identified below.

· You have 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 six years preceding 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 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 PHI for which you have already given us written authorization.  To request an accounting of the medical information about you that we have used or disclosed that is not exempted from the accounting requirement, contact the Privacy Officer identified below.

You have the right to request that we restrict the uses and disclosures of your PHI 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.  GHFD is not required to agree to any restrictions you request, but any restrictions agreed to by GHFD are binding on GHFD.

 

Right to Obtain a Copy of This Notice.  If we maintain a web site, this Notice will be prominently posted there and is electronically available to you.  You may request a paper copy of the Notice.

 

Revisions to this Notice.  The terms of this Notice may be changed at any time. The changes will be effective immediately and apply to all PHI that we maintain.  Any material changes to the Notice will be promptly posted in our facilities and posted to our web site, if we have one.  The Privacy Officer identified below will have a copy of the latest version of this Notice.

 

Your Legal Rights.  You have the right to complain to us or to the Secretary of the U. S. 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.  Any questions, comments or complaints may, be directed to the Privacy Officer identified below. 

 

If you have any questions or wish to file a complaint or exercise any rights listed in this Notice, please contact:

Chris Shook, Fire Chief / Privacy Officer, 1938 S. Hampton Rd., Glenn Heights, TX 75154 Telephone 972-223-1690 ext. 212.

                                 

 

Effective Date of the Notice:  April 14, 2004