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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.
Lifeline Healthcare is required by law to protect
certain aspects of your health care information known as Protected Health
Information or PHI and to provide you with this Notice of Privacy Practices.
This Notice describes our privacy practices, your
legal rights, and lets you know how Lifeline Healthcare 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
- How you may request restrictions on our use and disclosure of your
PHI.
In most situations we may use this information 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 THE:
HIPAA Privacy Liaison, and someone will
contact you.
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: This
Notice describes your legal rights, advises you of our privacy practices,
and lets you know how Lifeline Healthcare is permitted to use and disclose
Protected Health Information (PHI) about you.
Uses and Disclosures of PHI: Lifeline
Healthcare 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 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,
utililzation 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.
Use and Disclosure of PHI Without Your Authorization. Lifeline
Healthcare is permitted to use PHI without your written authorization,
or opportunity to object in certain situations, including:
- For Lifeline Healthcare’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 or First Responder Agencies) for the health care operations,
activities of the covered entity that receives the information as
long as the covered 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 compliances 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
a 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 based upon that authorization.
Patient Rights: As a patient,
you have a number or 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 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 for you to request access
to your PHI. 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 liaison listed at the end of this Notice.
The right to amend you PHI. The right
to request amending your PHI. You have the right
to ask us to amend written medical information that we may have
about you. If errors are found, 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, but only in
certain circumstances. For example, if we believe the information
is correct and no errors exist your request will be denied. If
your wish to request that we amend the medical information that
we have about you, you should contact in writing 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 purposed of treatment,
payment or health care operations, or when we share your health
information with our business associates, such as 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. However, 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. Lifeline
Healthcare is not required to agree to any restrictions you request,
but any restrictions agreed to by Lifeline Healthcare are binding
on Lifeline Healthcare.
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 your may always request
a paper copy of this Notice.
Revisions to the Notice: Lifeline
Healthcare reserves the right to change the terms of this Notice at
an 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 your 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 in this Notice, please contact:
Lifeline Healthcare, In administrative office at (858) 581-6400
Effective Date of the Notice: 03/25/2009
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