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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, McLane Fire &
Life Safety 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 McLane Fire & Life
Safety 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.
McLane
Fire & Life safety 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 by law 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 following
at all times.
PLEASE
READ THE ATTACHED DETAILED NOTICE.
IF YOU HAVE ANY QUESTIONS ABOUT IT, PLEASE OUR PRIVACY
OFFICER AT (360) 866-1000 or BY MAIL AT – 4131 Mud Bay Rd. SW,
Olympia, WA 98502
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.
Purpose
of this Notice:
McLane
Fire & Life Safety is required by law to maintain the
privacy of certain confidential health care information, known
as Protected Health Information or PHI, and to provide you with
a notice of our legal duties and privacy practices with respect
to your PHI. This Notice describes your legal rights, advises
you of our privacy practices, and lets you know how McLane Fire
& Life Safety is permitted to use and disclose PHI about
you.
McLane
Fire & Life Safety 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 by law to do so.
Uses and
Disclosures of PHI:
McLane Fire & Life Safety 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 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, 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 to provide you with a reminder of any
scheduled appointments 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.
McLane Fire & Life Safety is permitted to use PHI without
your written authorization, or opportunity to object in certain
situations, including:
·
For McLane Fire & Life Safety’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 your personal health information to your spouse when your
spouse has called the ambulance for you.
In situations 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
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 ambulance
crew;
·
To a public health authority in certain situations (such
as reporting a 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 to notify a person about exposure to
a 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 (or their contractors) by law to
oversee the health care system;
·
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 suspect 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 deceased person, determining cause of death, or
carrying 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 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 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 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 the right to access.
In limited circumstances, we may deny you access to your
medical 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.
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 to amend your medical
information only in certain circumstances, like when we believe
the information you have 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
privacy officer listed at the end of this Notice.
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 purposes of treatment,
payment or health care operations, or when we share your health
information with our business associates, like our billing
company or a medical facility from/to which we have transported
you.
We
are also not required to give you an accounting of our
uses of protected health information for which you have already
given us written authorization.
If you wish to request an accounting of the medical
information about you that we have used or disclosed that is not
exempted from the accounting requirement, you should contact the
privacy officer listed at the end of this Notice.
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 medical information that we have about you 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 a
health care provider to provide you with emergency treatment.
McLane Fire & Life Safety is not required to agree to
any restrictions you request, but any restrictions agreed to by
McLane Fire & Life Safety are binding on McLane Fire &
Life Safety.
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 through 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 the Notice.
Revisions to
the Notice: McLane Fire & Life Safety 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 Privacy Officer identified below.
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 or
to the government. Should
you have any questions, comments or complaints you may direct
all inquiries to the privacy officer listed at the end of this
Notice. Individuals
will not be retaliated against for filing a complaint.
If
you have any questions or if you wish to file a complaint or
exercise any rights listed in this Notice, please contact:
PRIVACY
OFFICER
McLane
Fire & Life Safety
4131 Mud Bay Rd. S.W.
Olympia, WA 98502
(360) 866-1000
Effective
Date of the Notice: April 14, 2003
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