Notice of Privacy Practices

BERWICK AREA AMBULANCE ASSOCIATION, INC.

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.

Berwick Area Ambulance Association, Inc. (BAAA) is required by law to maintain the privacy of certain confidential health 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.  BAAA is also required to abide by the terms of the version of this Notice currently in effect.

 

Uses and Disclosures: 

 

BAAA may use PHI for the purposes of treatment, payment and health care operations in most cases without your written permission.  Examples o of our use of your PHI…

·          For Treatment. This includes such things as obtaining verbal and written information about your medical condition and treatment from you as well as from others, such as doctors and nurses who give orders to allow us to provide treatment to you. We give your PHI to other healthcare providers involved in your treatment and may transfer your PHI via radio or telephone to the hospital or dispatch center. 

·          For Payment. This includes any activities we must undertake in order to get reimbursement for the services that we provide to you, including such things as submitting bills to insurance companies, making medical necessity determinations and collecting outstanding accounts. 

·          For Healthcare Operations. This includes quality assurance activities, licensing, and training programs to ensure that our personnel meet out standards of care and follow established policies and procedures, as well as certain other management functions

·          Reminders for Scheduled Transports and Information on Other Services. We may also contact you to provide you with a reminder of any scheduled appointments for non-emergency ambulance and medical transportation, or to provide information about other services we provide. 

 

Uses and Disclosures of Your PHI Without Your Authorization

 

BAAA is permitted to use or disclose your PHI without your written authorization, or opportunity to object in certain situations, and unless prohibited by a more stringent law, including:

·          For the treatment, payment or healthcare operations activities of another healthcare provider who treats you.

·          For healthcare and legal compliance activities.

·          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, and in certain other circumstances where we are unable to obtain your agreement and believe the disclosure is in your best interest. 

·          To a public health authority in certain situations as required by law (such as to child or adult abuse, neglect or domestic violence)

·          For health oversight activities including audits or government investigations, inspections, disciplinary proceedings and other administrative or judicial actions undertaken by the government for their contractors by law to oversee the healthcare 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. 

·          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 as large;

·          For worker’s compensation purposes and in compliance with worker’s 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. 

·          We may also use or disclose health information 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.  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 your PHI, including:

 

Right to access, copy or inspect your PHI.  This means you have the right to inspect and copy most of the medical information that we collect and maintain about you. We will normally provide you with access to your PHI within 30 days of your We may charge you a reasonable fee for you to copy any medical information that you have the right to access.  And in limited circumstances we may deny your access your medical information and may appeal certain types of denials.  We have available forms at your request access to your PHI and we will provide a written response if we deny your access and let you know your appeal rights.  You also have the right to receive confidential communications of your PHI.  If you wish to inspect or copy your medical information you should contact our privacy officer. 

Right to amend your PHI. You have the right to ask us to amend written medical information that we may have about you. We would 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 medial 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. 

Right to request an accounting.  You may request an account from us of certain disclosures of your medical information that we have made in the last six (6) years prior to the date of your request.  We are not required to give you an accounting of information that we have used or disclosed for 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 which to request an accounting, contact our privacy officer. 

Rights 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.  BAAA is not required to agree to any restrictions you request, but any restrictions agreed to by BAAA in writing are biding on BAAA

Internet, Email and the Right to Obtain Copy of Paper Notice of request.  If we maintain a web site, we will prominently post a copy of this Notice on our 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.  BAAA 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 facility and on our web site, if we maintain one. You can get a copy of the latest version of the Notice by contacting our privacy officer. 

Your Legal Rights and Complaints.  You may 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 that 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 inquiries to the privacy officer. 

 

Privacy Officer Contact Information

Privacy Officer

Berwick Area Ambulance Association, Inc.

2018 N. Vine Street

Berwick, PA 18603

(570)-752-5321

 

Effective Date of this Notice:  April 14, 2003

Company Information

Berwick Area Ambulance Association Inc. is a non-profit organization providing 24 hours a day, 7 days a week ambulance coverage to the Greater Berwick Area and many surrounding communities and has been in service since 1959. We provide 911 service coverage to over 250 square miles in both Columbia and Luzerne Counties. Our ambulance services are based out of two locations one in Berwick Borough and one in Mocanaqua staged at the Mocanaqua Volunteer Fire Company.

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