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Privacy
Statement:
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,
Union Township Fire Rescue maintains the privacy of certain
confidential health care information about you, known as Protected
Health Information or PHI. We are required by law to protect your
health care information and to provide you with the attached Notice
of Privacy Practices.
The notice outlines our legal duties and
privacy practices respect to your PHI. It not only describes our
privacy practices and your legal rights, but lets you know, among
other things, how Union Township Fire Rescue 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.
Union Township Fire Rescue 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 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 the
following at all times.
PLEASE READ THE ATTACHED DETAILED NOTICE. IF
YOU HAVE ANY QUESTIONS ABOUT IT, PLEASE CONTACT DEPUTY CHIEF JAMES
BUTLER, OUR PRIVACY OFFICER, AT 513-494-2566.
Purpose of this notice: Union Township Fire
Rescue is required by law to maintain the privacy of certain
confidential health care information, known as Protected Health
Information or PHI, and provide you with a notice of our legal
duties and privacy practices with respect to your PHI. This notice
describes your legal rights, advised you of our privacy practices,
and lets you know how Union Township Fire Rescue is permitted to use
and disclose PHI about you.
Union Township Fire Rescue is also required 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 to do so by law to do so.
Uses and disclosure of PHI: Union Township
Fire Rescue 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 to 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 you, including such things as organizing your PHI and
submitting bills to insurance companies (either directly or through
a third party company), management of billed claims for services
rendered, medical necessity determinations and reviews, utilization
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, fundraising, and certain marketing
activities.
Reminders for Scheduled Transports and
Information on Other Services. We may also contact you with a
reminder of any scheduled appointment s for non-emergency ambulance
and medical transportation, or for other information about
alternative services we provide or other health-related benefits and
services that may be of interest to you. Use and Disclosure of PHI
Without Your Authorization. Union Township Fire Rescue is
permitted to use PHI without your written authorization, or
opportunity to object in certain situations, including:
For Union Township Fire Rescue’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) 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 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 you PHI to your spouse when your spouse has called the
ambulance for you. In situation 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 only disclose health
information relevant to that persons involvement in your care. For
example, we may inform the person whom 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 h authority in certain
situations (such as reporting a birth, death, or disease that is
required by law, as a 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 governments investigations, inspections, disciplinary
proceedings, and other administrative or judicial actions undertaken
by the government (or their contractors) by law to over see health
care operations;
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 person 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 decease person, determining cause of
death, or carrying on their duties as authorized by law;
If you are an organ donor, we may release the
health information to organizations that handle organ procurement
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 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 anytime in
writing, except to the extent that we have already used or disclosed
medical information in reliance to that authorization.
Patient Rights: As a patient you have a
number of rights with the 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 a right to access. In
limited circumstances, we may deny you access to your 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 the privacy
officer listed at the end of this notice.
Deputy Chief JAMES BUTLER
Union Township Fire Rescue
285 EAST PIKE STREET
SOUTH LEBANON, OHIO 45065
513-494-2566
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