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.
Nazareth Volunteer Ambulance Corps ("Nazareth") will use your medical information as part of rendering patient care. For example, your medical information may be given to the hospital we transport you to and used by the hospital to render care, by our billing company to process your payment for the services we have provided, and by our administrative personnel for health care operations. i.e. reviewing the quality of care you receive.
Uses and Disclosures
Nazareth may also use and/or disclose your protected health information, PHI, in accordance with federal and state laws for the following purposes:
"We may contact you when we are in the process of raising funds for Nazareth, or to provide you with information about our annual subscription program."
"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."
"For the treatment, payment or health care operations of another health care provider or in accordance with the activities of a business associate."
"For health care fraud and abuse detection or for activities related to compliance with the law."
"To a personal representative responsible for your health care, unless you object."
"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 or in situations where you are not capable of objecting (because you are not present or due to your incapacity or medical emergency)"
"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 investigations, 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 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 judicial and administrative proceedings as required by a court or administrative order.
For military, national defense and security and other special government functions.
To avert a serous 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.
As permitted or required by law.
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.
The right to access your PHI. 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. We will also make every attempt to accommodate patient requests for access to PHI by alternative means or locations.
The right to copy or inspect your PHI. This right is subject to certain specific exceptions and you may be charged a reasonable fee for copies.
The right to amend your PHI. 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.
The right to an accounting of our uses and disclosures of your PHI in the six years prior to your request, except for disclosures for treatment, payment or health care operations, and for certain other specific disclosure types.
The right to request that we restrict the uses and disclosures of your PHI. 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 disclosure the PHI to a health care provider to provide you with emergency treatment. Nazareth Volunteer Ambulance Corps is not required to agree to any restrictions you request, but any restrictions agreed to by Nazareth Volunteer Ambulance Corps are binding on Nazareth Volunteer Ambulance Corps.
The right to complain to our Privacy Officer and/or the U.S. Department of Health and Human Services if you believe we have violated your privacy rights.
The right to obtain a copy of this Notice. If we maintain a web site, we will make the Notice available electronically through the web site. Otherwise, we will forward you this Notice by electronic mail or a paper copy via regular mail.
Nazareth reserves the right to modify the terms of this Notice at any time. Changes are effective immediately. Any material change to the Notice will be promptly posted in our facilities and on our website, if one exits. If you have any questions or if you wish exercise any rights listed in this Notice, please contact:
Nazareth Volunteer Ambulance Corps
519 Seip Avenue
Nazareth, PA 18064