Millville Fire Rescue Notice of Privacy Practices

This notice describes how your medical information may be used and disclosed any how you can get access to it.  Please review it carefully.

Purpose of this notice: Millville Fire Rescue (MFR) is required by law to maintain the privacy of certain confidential health care information.  This information is known as Protected Health information PHI.  MFR is required to provide you with a notice of our legal duties and privacy practices with respect to you PHI.  This notice describes your legal rights, advises you of our privacy practices, and lets you know how MFR is permitted to use and disclose your PHI.
MFR is also required to abide by the terms of version of the notice currently in effect.  In most situations we may use this information without your permission, but some situations we may only use you PHI with written authorization, if we are required to do so by law.

Uses and Disclosures of PHI: MFR may use PHI for the purpose of treatment, payment, and health care operations, in most cases without you written permission. 

For treatment: This includes such things as verbal and written information we obtain about your and use pertaining to your medical condition and treatment; provided to you by us and other medical personnel (doctors and nurses who give orders to allow us to provide treatment to you).  It also include, information we give to other health care personnel to whom we transfer care.  It includes transfer of PHI via radio or telephone to the hospital or dispatch center as well as providing the hospital with a copy of written record we create into the course of providing you with treatment and transport.

For payment: This includes any activities we must undertake to get reimbursed for the services we provide to you.  This includes such things as organizing you PHI and submitting bills to insurance companies (directly or through a third party billing company), management of billed claims for service rendered, medical necessity determinations and reviews, utilization review, and collection of outstanding accounts.

For health care operations: This includes quality assurance actives, 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.

Use and Disclosure of PHI without You Authorization: MFR is permitted use of PHI without your written authorization, or opportunity to object in certain situations, including:
For MFR use in treating you or in obtaining payment for service provided to you or in other health care operations.
For the treatment activities of another heath 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 operation activities of the entity that receives the information as long as the entity receiving the information has had a relationship with you and the PHI pertains to that relationship.

 

To a family member, relative or close personal friend or other individual involved in you care if we obtain a verbal agreement to do so or if we you an opportunity to object to such a disclosure and you do not raise and 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 disclose of your PHI to you spouse when your spouse has called the ambulance for you.  In situations where you are not capable of objecting (you are not present do to your incapacity or medical emergency), we may, in our professional judgment, determine that a disclosure to your family member, relative, or close 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 personnel.

To a public health authority in certain   situations (such as reporting 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 the notify a person about exposure to 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 by law to oversee the health care system.
For judicial and administrative proceedings as required by a court 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 request, or when information is needed to locate a suspect or to stop a crime.
For military, national defense and security and other special government functions.
To avert serious thereat 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 carry 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.
For research project, but this will be subject to strict oversight and approvals.
We may use or disclose PHI 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 office and inspect and copy most of the medical information about you 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 medical information, and you may appeal certain types of denials.
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 60 days of your request and will notify you when we have amended the information.  We are permitted by law to deny your request only in certain circumstances, like when we believe the information you 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 the fire chief.

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 the purpose of treatment, payment, health care operations.  Or when we share you PHI with our business associates, like our billing company or medical facility from/to which we have transported you.

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 PHI that we have about 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.  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 health care provider to provide you with emergency treatment.

Millville Fire Rescue is not required to agree to any restrictions you request, but any restrictions agreed to by Millville Fire Rescue are binding on Millville Fire Rescue.
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 though 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 this Notice.

Revisions to the Notice:  Millville Fire Rescue 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, if we maintain one.  You can get a copy of the latest version of this Notice by contacting the Fire Chief.

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 to the government.  Should you have any questions, comments or complaints you may direct all inquiries to the fire chief listed at the end of this Notice.  Individuals with not be retaliated against for filing a complaint.

If you have any question or if you with to file a complaint or exercise any rights listed n this Notice, please contact:

Chief John J. Mullaly
Millville Fire Rescue
196 Main St.                                                                                     
Millville, MA  01529

www.millvillefd.com

Effective Date of the Notice:    6 March 2008