Notice of Privacy Practices

The Squad is required by law to maintain the privacy of certain confidential health care information, known as 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 the Squad is permitted to use and disclose PHI about you. The Squad 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.

The Squad may use PHI for the purposes of treatment, payment, and health care operations, in most cases without your written permission. Examples include:

• For treatment. This includes 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. It also includes information we give to other health care personnel to whom we transfer your care and treatment, including 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 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.
  Note — The Martinsville Rescue Squad, Inc. does not bill for our services.
• 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 a reminder of any scheduled appointments for non-emergency ambulance and medical transportation, or other information about alternative services we provide or other health-related benefits and services that may be of interest to you.

The Squad is permitted to use PHI without your written authorization, or opportunity to object, in certain situations, including:

• For the Squad's use in treating you, 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;
• 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 that entity 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, 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 and you do not raise one. 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 disclosure 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 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, limited to information relevant to that person's involvement in your care;
• 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, 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) 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;
• 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 out their duties as authorized by law;
• If you are an organ donor, we may release health information to organizations that handle organ procurement, organ/eye/tissue transplantation, or an organ donation bank, as necessary to facilitate donation and transplantation;
• For research projects, subject to strict oversight and approvals, released only when there is 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 (which must specifically identify the information we seek to use or disclose, and 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, copy, or inspect your PHI. You may come to our offices and inspect and copy most of the medical information about you that we maintain. We will normally provide access within 30 days of your request, and may charge a reasonable fee for copies. In limited circumstances we may deny access, and you may appeal certain types of denials.
• The right to amend your PHI. You may ask us to amend written medical information we have about you. We will generally amend your information within 60 days of your request and notify you when we have. We are permitted by law to deny your request only in certain circumstances, such as when we believe the information is already correct.
• The right to request an accounting of our use and disclosure of your PHI. You may request an accounting of certain disclosures made in the six years prior to your request. We are not required to account for disclosures made for treatment, payment, or health care operations, disclosures to our business associates, or disclosures for which you have already given written authorization.
• The right to request that we restrict the uses and disclosures of your PHI. You may request that we restrict how we use and disclose your information for treatment, payment, or health care operations, or restrict what is shared with family, friends, and others involved in your care. If the restricted information is needed to provide you with emergency treatment, we may still use or disclose it to a health care provider for that purpose. The Squad is not required to agree to a requested restriction, but any restriction it does agree to is binding on the Squad.
• The right to receive this notice electronically, and to request a paper copy. If we maintain a website, we will prominently post a copy of this Notice on it and make it available electronically. If you allow us, we will send you this Notice by email instead of on paper, and you may always request a paper copy.

The Squad reserves the right to change the terms of this Notice at any time; 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 to our website, if we maintain one.

You 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 with the government.

If you have any questions, or wish to file a complaint or exercise any right listed in this Notice, please contact: