SUMMARY OF NOTICE OF PRIVACY PRACTICES
This is a summary of a notice that describes how medical information about you that is maintained by MCEMSS may be used and disclosed. This notice also tells you how to get access to these facts.
MCEMSS consists of all employed nurses, paramedics and EMT’s, and other personnel, and our affiliated entities. This notice applies to services given to you at any MCEMSS site.
Our Privacy Obligations: We must by law maintain the privacy of your Protected Health Information (PHI). When we disclose your PHI we must comply with the full terms of our Notice of Privacy Practices. In all cases where we may share your PHI with others, we will provide only the minimum necessary data to meet the need or request.
PHI Uses without Your Written Authorization: There are times when we may use and disclose your PHI without your written authorization. This may include treatment, payment, and our health care operations (which may involve administrative, quality and cost studies or activities to improve the care we give to all patients). Also, this may include persons who gave you care in conjunction with our services, but are not employed by us-for example, MICU interface personnel, helicopter EMS personnel, hospital physicians and nurses, etc. We may also share PHI with nurses, paramedics, EMT’s, health care students and other staff for teaching purposes. Since we do not operate a hospital facility, we do not maintain a patient directory, and as such, will not use or disclose your information for directory purposes.
Other examples (further defined in the attached NPP) include PHI made known to: your relative, close friends or other caregivers (identified by you whenever possible; public health activities; reporting of abuse, neglect or domestic violence as required by law; health oversight activities; judicial and administrative proceedings; law enforcement officials; medical examiner, coroner or funeral director; organ and tissue procurement; research; health and safety; specialized government functions; workers’ compensation; military command authorities if you are a member of the armed forces; national security and intelligence activities; protective services for the President and others; correctional institutions or law enforcement officials if you are an inmate; as otherwise required by law; and fundraising. If you do not want to receive any fundraising requests in the future, you may contact our Privacy Office at (251) 343-7131.
PHI Uses with Your Authorization: For any purpose other than those listed above, your PHI may only be used with your written consent. For example, we would need your written authorization in order to send your records to your life insurance company. We also need your written authorization to use or disclose your PHI for marketing purposes; and/or information about HIV/AIDS; sexually transmitted diseases; tuberculosis, and /or psychotherapy notes.
Your Rights about Your Protected Health Information:
The Right to Inspect and Copy your Information: You may review and copy your medical records and information, to the extent allowed by Alabama State Law, and where your rights are not limited by Federal law. You should make such a request to us at P.O. Box 289, Semmes, Alabama 36575. This request must be made in writing. We have the right to charge a reasonable fee for all copying and mailing expenses.
The Right to Amend: You may ask that we amend your health information if you believe that your information is incomplete or incorrect. A request for an amendment should be made in writing and should be sent to us at the above address. Your request must be accompanied by a statement from you regarding why you feel the amendment is proper. We will not process your request if it is not in writing or does not tell us why you think the amendment is appropriate. We will act on your request within 30 days or less if state law requires (or 60 days if the extra time is needed), and will inform you in writing as to whether the amendment will be made or denied. If we agree to make the amendment, we will ask you who else you would like us to notify of the amendment.
We may deny your request if you ask us to amend information that:
was not created by us, unless the person who created the information is no longer available to make the amendment;
is not part of the PHI we keep about you;
is not part of the PHI that you would be allowed to see or copy; or
is determined by us to be accurate and complete.
If we deny the requested amendment, we will tell you in writing how to submit a statement of disagreement or complaint, or to request inclusion of your original amendment request in your PHI.
The Right to Request Limits on Uses and Disclosures of Your PHI. You have the right to ask us to limit how we use and disclose your PHI. Any such requests must be submitted in writing to our Privacy Officer. We are not required to agree to your request. If we do agree, we will put it in writing and will abide by the agreement except when you require emergency treatment.
The Right to Choose How We Communicate With You: You have the right to ask that we send information to you at a specific address (for example, at work rather than at home) or in a specific manner (for example, by e-mail rather than by regular mail, or never by telephone). We must area to your request as long as it would not be disruptive to our operations to do so. You must make any such request in writing, addressed to our Privacy Officer.
The Right to Get a List of the Disclosures We Have Made: You have the right to get a list of instances in which we disclosed your PHI. The list will not include disclosures we have made for treatment, payment and health care operations purposes, those made directly to you or your family or friends or through our facility directory, or for disaster relief purposes. Neither will the list include disclosures we have made for national security purposes or to law enforcement personnel, or disclosures made before April 14, 2003.
Your request for a list of disclosures must be made in writing and be addressed to the Patient Billing Service Center address that is listed on your invoice. We will respond to your request within 30 days or less if state law requires (or 60 days if the extra time is needed). The list we provide will include disclosures made within the last six years unless you specify a shorter period. The first list you request within a 12-month period will be free. You will be charged our costs for providing any additional lists within the 12-month period.
The Right to Get a Paper Copy of This Notice. Even if you have agreed to receive the Notice by e-mail, you have the right to request a paper copy as well. You may obtain a paper copy of this Notice by contacting the Compliance Department at 251-343-7131. The Notice is also available on-line at mcemss.com.
If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the Federal Department of Health and Human Services. To file a complaint with the DHHS put your complaint in writing and address it to the US Department of Health & Human Services, 200 Independence Ave. S.W., Washington DC, 20201. Or call them at 877-696-6775. To file a complaint with us, put your complaint in writing and address it to our Privacy Officer at P.O. Box 850337, Mobile, AL 36685-0337. We will not retaliate against you for filing a complaint. You may also contact our Privacy Officer if you have questions or comments about our privacy practices.
Effective Date: April 12, 2003.