NOTICE OF PRIVACY PRACTICES
Muskogee County Emergency Medical Services
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
Your health information is personal, and Muskogee County EMS is committed to protecting it. We are required by law to maintain the privacy of health information that could be used to identify you (PHI). The law requires us to provide you with a copy of this Notice of Privacy Practices (Notice), which describes our privacy practices and our legal duties with respect to PHI. Under certain circumstances, we may also be required to notify you following a breach of unsecured PHI.
HOW WE MAY USE OR DISCLOSE YOUR PHI
Treatment. We may use or disclose your PHI in connection with our treatment or transportation of you. For example, we may disclose your PHI to doctors, nurses, technicians, medical students or any other health care professional involved in taking care of you. We may also provide information about you to a hospital or dispatch center via radio, telephone or other electronic means. We may provide a hospital or other health care facility with a copy of the medical records created by us or used by us in the course of treating or transporting you.
Payment. This includes any activities we must undertake in order to be 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, medically necessary determinations and reviews, utilization reviews, collection of outstanding accounts, and similar activities.
Health care operations. We may use and disclose your PHI for quality assurance activities, licensing and training programs to ensure that our personnel meet our standards for care, and to ensure that our personnel follow our established policies and procedures. We may also use your information for obtaining legal, financial or accounting services, conducting business planning, processing complaints, and for the creation of reports that do not individually identify you.
Fundraising. Muskogee County EMS may use your PHI for certain fundraising activities, or to provide you with information about our annual subscription program. You have the right to opt out of fundraising communications by submitting a written request to: Privacy Officer, Muskogee County EMS, 200 Callahan, Muskogee, OK 74403 or by calling the Privacy Officer at 918-683-0130 or 800-372-8008. In no event will the provision of medical care be conditioned on your willingness to receive, or your refusal of, fundraising communications.
Reminders and other information. We may also contact you to provide you with a reminder of scheduled appointments for non-emergency ambulance and/or 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.
Other uses or disclosures that do not require authorization. The law permits us to use or disclose your PHI without your authorization in the following circumstances:
USES OR DISCLOSURES WHERE YOU HAVE THE RIGHT TO OBJECT
Unless you object, we may provide relevant portions of your PHI to a family member, friend, or other person that is involved in making decisions about your health care, or in paying for your health care. We may use or disclose PHI to notify your family member, friend, or personal representative about your condition. In an emergency or when you are not capable of agreeing or objecting to these disclosures, we will disclose your PHI only to the extent we reasonably believe such disclosure to be in your best interest. After the emergency has passed, you are free to object to any future disclosures to family, friends, or personal representatives. Also, unless you object, we may disclosure your PHI to persons involved in providing disaster relief, for example, the American Red Cross.
USES OR DISCLOSURES THAT REQUIRE YOUR WRITTEN CONSENT
Any other use or disclosure of PHI, other than those listed above will only be made with your written authorization. The law also requires your written authorization before we may use or disclose: (i) psychotherapy notes, other than for the purpose of carrying out our treatment, payment, or health care operations purposes, (ii) any PHI for our marketing purposes or, (iii) any PHI as part of a sale of PHI. You may revoke a previous written authorization in writing at any time. If you elect to revoke a previous authorization, we will immediately stop any further uses or disclosures of your PHI for the purposes set out in the written authorizations to the extent we have not already acted in reliance on your authorization; however, we will be unable to retract any disclosures previously made with your permission.
YOUR RIGHTS WITH RESPECT TO YOUR PHI
You have the following rights with respect to your PHI:
NOTIFICATION IN THE EVENT OF AN UNAUTHORIZED USE OR DISCLOSURE
The law may require us to notify you in the event of an unauthorized use or disclosure of your unsecured PHI. To the extent we are required to notify you, we must do so no later than 60 days following our discovery of such unauthorized use or disclosure. This notification will be made by first class mail or email (if you have indicated a preference to be notified by email), and must contain the following information:
CHANGES TO THIS NOTICE
Muskogee County EMS is required to comply with the terms of this Notice as currently in effect. We reserve the right to change or amend our privacy practices at any time in the future, and to make any changes applicable to PHI already in our possession. This Notice will be revised to reflect any changes in our privacy practices. You may obtain a copy of our revised Notice by contacting our Privacy Officer. We will also make any revised Notice available on our website at: http://www.mcems.us
If you have questions or comments about our privacy practices, or if you would like to obtain additional information regarding your privacy rights, please contact our Privacy Officer at: Muskogee County EMS, 200 Callahan, Muskogee, OK 74403. You may also contact our Privacy Officer by phone at: 918-683-0130 or 800-372-8008.
If you believe that your privacy rights have been violated you may file a complaint with Muskogee County EMS or with the Secretary of the Department of Health and Human Services (DHHS). To file a complaint with us, please put your complaint in writing and mail it to the following address: Privacy Officer, 200 Callahan, Muskogee, OK 74403. You may also contact our Privacy Officer by phone at: 918-683-0130 or 800-372- 8008. To file a complaint with the DHHS, you must put your complaint in writing and mail it to: Office for Civil Rights, U.S. Department of Health and Human Services, 200 Independence Avenue, S.W., Washington, D.C. 20201. You will not be retaliated against or denied any health services if you elect to file a complaint.
Effective Date: April 14, 2003 Revision Date: September 01, 2013
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