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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.
As an essential part of our commitment to you, Cataldo Ambulance
Service maintains the privacy of certain confidential healthcare
information about you, known as Protected Health Information, or
PHI. We are required by law to protect your healthcare information
and to provide you with the attached Notice of Privacy Practices.
The Notice outlines our legal duties and privacy practices with
respect to your PHI. It not only describes our privacy practices
and your legal rights, but lets you know, among other things, how
Cataldo Ambulance Service 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.
Cataldo Ambulance Service 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 healthcare 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 ATTACHED DETAILED NOTICE.
If you have any questions about it, please contact P. Kevin Foley,
our Privacy Officer,
at (617) 625-0126.
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: Cataldo Ambulance Service,
Inc. is required by law to maintain the privacy of certain confidential
healthcare 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 Cataldo Ambulance Service is permitted to use and disclose PHI
about you.
Cataldo Ambulance Service 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 Disclosers of PHI: Cataldo Ambulance may use PHI
for the purposes of treatment, payment, and healthcare 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 healthcare 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 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, obtaining legal and financial services, conduction
business planning, processing grievances and complaints, creating
reports that do not individually identify you for data collection
purposes, fundraising, and certain marketing activities.
USES AND DISCLOSURES OF PHI WITHOUT YOUR AUTHORIZATION.
Cataldo Ambulance is permitted to use PHI without your written authorization,
or opportunity to object in certain situations, including:
For Cataldo Ambulance’s use in treating you or in obtaining
payment for services provided to you or in other health care operations;
For treatment activities of another health care provider;
To another health care provider (such as the hospital to which you
are transported) for 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 or 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 Somerville office 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 three (3) business
days of your request. We may also charge you a reasonable fee for
you to copy any medical information that you have a 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 our Privacy Officer whose name and contact information
is 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 five (5) business
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 our Privacy Officer whose
name and contact information is 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 medial 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 the purposes of treatment, payment or healthcare 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 that we have used or disclosed that is not exempt
from the accounting requirement, you should contact our Privacy
Officer whose name and contact information is 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 healthcare operations, or to restrict
the information that is provided to family, friends, and other individuals
involved in your healthcare. 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 healthcare provider to provide you with emergency treatment.
Cataldo Ambulance Service is not required to agree to any restrictions
you request, but any restriction agreed to by Cataldo Ambulance
is binding on Cataldo Ambulance Service, Inc.
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. Cataldo Ambulance Service,
Inc. 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. You can get a copy of the latest version
of this Notice by contacting our Privacy Officer whose name and
contact information is at the end of this Notice.
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 the government. Should you have
any questions, comments, or complaints you may direct all inquires
to our 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 in this Notice, please contact:
P. Kevin Foley, Privacy Officer
Cataldo Ambulance Service, Inc.
137 Washington, Street P.O. Box 435
Somerville, MA 02143
(617) 625-0126
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