NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU (AS PATIENT OF THE INDEPENDENCE FIRE DEPARTMENT) MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO YOUR INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION.
PLEASE REVIEW THIS INFORMATION CAREFULLY!OUR COMMITMENT TO YOUR PRIVACY
The Independence Fire Department is dedicated to maintaining the privacy of your protected health information (PHI). In conducting our business, we will create records regarding you and the treatment and services we provide to you. We are required by law to maintain the confidentiality of health information that identifies you. We also are required by law to provide you with this notice of our legal duties and the privacy practices that we maintain in the Independence Fire Department concerning your PHI. By federal and state law, we must follow the terms of the notice of privacy practices that we have in effect at the time.
We realize that these laws are complicated but we must provide you with the following important information:
- How we may use and disclose your PHI,
- Your privacy rights,
- Our obligations concerning the use and disclosure of your PHI.
The terms of this notice apply to all records containing your PHI that are created or retained by the Independence Fire Department. We reserve the right to revise or amend this Notice of Privacy Practices. The Independence Fire Department will post a copy of our current Notice in our offices in a visible location, at all times, and you may request a copy of our most current notice at any time.IF YOU HAVE QUESTIONS ABOUT THIS NOTICE OR WOULD LIKE TO EXERCISE ANY OF YOUR RIGHTS UNDER THIS NOTICE, PLEASE CONTACT CHIEF STEVE REGA.
WE MAY USE AND DISCLOSE YOUR PROTECTED HEALTH INFORMATION (PHI) IN THE FOLLOWING WAYS:
- 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 with a copy of the written record we create in the course of providing you with treatment and transport.
- The Independence Fire Department may use and disclose your PHI to bill and collect payment for the services and items you receive from us. For example, we may provide your insurer with details regarding your treatment to determine if your insurer will cover, or pay for, your treatment. We also may use and disclose your PHI to obtain payment from third parties that may be responsible for such costs, such as family members. Also, we may disclose your PHI to other health care providers for their payment purposes.
- Health Care Options. The Independence Fire Department may use and disclose your PHI to operate our business. As examples of the way in which we may use and disclose your information for our operations, the Independence Fire Department may use your PHI to evaluate the quality of care you received from us, or to conduct cost-management and business planning activities for the Independence Fire Department.
- Disclosures Required by Law. The Independence Fire Department will use and disclose your PHI when we are required to do so by federal, state, or local law.
USE AND DISCLOSURE OF YOUR PHI IN CERTAIN SPECIAL CIRCUMSTANCES
- Public Health risks. We may disclose PHI about you for public health activities.
- Health Oversight Activities. The Independence Fire Department may disclose your PHI to a health oversight agency for activities authorized by law.
- Lawsuits and Similar Proceedings. The Independence Fire Department may use and disclose your PHI in response to a court or administrative order.
- Law Enforcement. We may release PHI if asked to do so by a law enforcement official.
- Deceased Patients. The Independence Fire Department may release PHI to a medical examiner or coroner to identify a deceased individual or to identify the cause of death. If necessary, we also may release information in order for funeral directors to perform their jobs.
- Serious threats to Health or Safety. The Independence Fire Department may use and disclose your PHI when necessary to reduce or prevent a serious threat to your health and safety or the health and safety of another individual or the public.
- The Independence Fire Department may disclose your PHI if you are a member of a U.S. or a foreign military force (including veterans) and if required by the appropriate authorities.
- National Security. The Independence Fire Department may disclose your PHI to federal officials for intelligence and national security activities authorized by law. We also may disclose your PHI to federal officials in order to protect the President, other officials or foreign heads of state or to conduct investigations.
- Workers’ Compensation. The Independence Fire Department may release your PHI for workers’ compensation and similar programs.
YOUR RIGHTS REGARDING YOUR PHI
You have the following rights regarding the PHI that we maintain about you;
- Confidential Communications. You have the right to ask that we contact you at an alternate address or by alternate means.
- Requesting Restrictions. You have the right to ask that we limit how we use or disclose your PHI. We will consider your request, but are not legally bound to agree to the restriction.
- Inspection and Copies. You have the right to inspect and to receive a copy of your protected health information that may be used to make a decision about your care. Usually this includes medical and billing records. If you request a copy of your information, we may charge a fee for the costs of copying, mailing, or other supplies associated with your request. In limited circumstances, we may deny your request to inspect and copy your PHI and the reason for denial will be provided to you.
- You have the right to request that we amend (correct, supplement) your PHI that the Independence Fire Department maintains. NOTE: This request must be submitted in writing. If you believe that we have information that is either inaccurate or incomplete, we may amend the information to indicate the problem and notify others who have copies of the inaccurate or incomplete information. We may deny your request under certain circumstances. A reason for the denial will be provided to you.
- Accounting of Disclosures. You have the right to receive a detailed listing of disclosures other than instances of disclosure for which you gave consent or signed an authorization (examples include for treatment, payment, operations, law enforcement, or to you or your family). This list must be submitted in writing and include your name, title, address and a time period, which may not be longer than six (6) years and may not include dates before 4/1/2003. There will be no charge for up to one (1) list per year. For additional lists, there may be a fee to cover the costs of preparing the list.
- Right to a Paper Copy of This Notice. You are entitled to receive a paper copy of our Notice of Privacy Practices. You may ask us to give you a copy of this notice at any time.
- Right to File a Complaint. If you believe your privacy rights have been violated, you may file a complaint with the Independence Fire Department or the Secretary of the Department of Health and Human Services. All complaints must be submitted in writing. You will not be penalized for filing a complaint.
OTHER USES OF PROTECTED HEALTH INFORMATION
Other uses and disclosures of medical information not included in this notice or by laws that apply to its use will be made only with your written authorization. If you provide us with permission to use or disclose medical information about you, you may revoke that authorization in writing at any time. If you revoke your authorization, we will no longer use or disclose medical information about you for the reasons covered by your written request. NOTE: We are unable to take back any disclosure that we have already made with your authorization or pursuant to this Notice of Privacy practices. Additionally, we are required by law to retain records of the care that we provided to you for a specific period of time.
Again, if you have any questions regarding this notice or our health information policy, please contact the Independence Fire Chief.