HIPPA Notice of Privacy Practices

Central Huron Ambulance Services is required by law to maintain the privacy of certain confidential health care information, known as Protected Health Information or PHI, to provide you with a notice of our legal duties and privacy practices with respect to your PHI. Central Huron Ambulance Services is also required to abide by the terms of the version of this Notice currently in effect.

Uses and Disclosures of PHI:Central Huron Ambulance Services may use PHI for the purpose 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 obtaining verbal and written information about your medical condition and treatment from you as well as from others, such as doctors and nurses who give orders to allow Central Huron Ambulance Services to provide treatment to you. Central Huron Ambulance Services may give your PHI to other health care providers involved in your treatment and may transfer your PHI via radio or telephone to the hospital or dispatch center.

For payment. This includes any activities Central Huron Ambulance Services must undertake in order to get reimbursed for the services provided to you, including such things as submitting bills to insurance companies, making medical necessity determinations and collecting 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, as well as certain other management functions.

Reminders for Scheduled Transports and Information on Other Services. Central Huron Ambulance Services may also contact you to provide you with a reminder of any scheduled appointments for non-emergency ambulance and medical transportation, or to provide information about other services we render.

Use and Disclosure of PHI Without Your Authorization. Central Huron Ambulance Services is permitted to use PHI without your written authorization, or opportunity to object, in certain situations, and unless prohibited by a more stringent state law, including:

  • For the treatment, payment or health care operations activities of another health care provider who treats you;
  • For health care and legal compliance activities;
  • To a family member, other relative, or close personal friend or other individual involved in your care if Central Huron Ambulance Services  obtains your verbal agreement to do so or if Central Huron Ambulance Services  give you an opportunity to object to such a disclosure and you do not raise an objection, and in certain other circumstances where Central Huron Ambulance Services  is unable to obtain your agreement and believe the disclosure is in your best interests;
  • To a public health authority, in certain situations as required by law (such as to report abuse, neglect or domestic violence);
  • For health oversight activities, including audits or government investigations, inspections, disciplinary proceedings, and other administrative of 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 responding to a warrant;
  • 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, Central Huron Ambulance Services 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, subject to strict oversight and approvals;
  • Central Huron Ambulance Services may also 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. You may revoke your authorization at any time, in writing, except to the extent that Central Huron Ambulance Services has 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 your PHI, including:

The right to access, copy or inspect your PHI. This means you may inspect and copy most of the medical information about you that we maintain. Central Huron Ambulance Services will normally provide you with access to this information within 30 days of your request. Central Huron Ambulance Services may also charge you a reasonable fee for you to copy any medical information that you have the right to access. In limited circumstances, Central Huron Ambulance Services may deny you access to your medical information, and you may appeal certain types of denials. Central Huron Ambulance Services has available forms to request access to you PHI and Central Huron Ambulance Services will provide a written response if Central Huron Ambulance Services denies you access and let you know your appeal rights. You also have the right to receive confidential communications of your PHI. If you wish to inspect and copy your medical information, you should contact our Privacy Officer.

The right to amend your PHI. You have the right to ask Central Huron Ambulance Services

to amend written medical information that Central Huron Ambulance Services may have about you. Central Huron Ambulance Services will generally amend your information within 60 days of your request and wi” notify you when Central Huron Ambulance Services has amended the information. Central Huron Ambulance Services is permitted by law to deny your request to amend your medical information only in certain circumstances, like when Central Huron Ambulance Services believes the information you have asked us to amend is correct. If you wish to request that Central Huron Ambulance Services amend the medical information that we have about you, you should contact our Privacy Officer.

The right to request an accounting. You may request an accounting from us of certain disclosures of your medical information that Central Huron Ambulance Services has made in the six

(6) years prior to the date of your request. Central Huron Ambulance Services  is not required to give you an accounting of information that Central Huron Ambulance Services  has used or disclosed for purposes of treatment, payment or health care operations, or when Central Huron Ambulance Services  shares your health information with Central Huron Ambulance Services  business associates, such as Central Huron Ambulance Services  billing company or a medical facility from/to which Central Huron Ambulance Services  has transported you. Central Huron Ambulance Services is also not required to give you an accounting of Central Huron Ambulance Services uses of Protected Health Information for which you have already given Central Huron Ambulance Services written authorization. If you wish to request an accounting, contact our Privacy Officer.

The right to request that Central Huron Ambulance Services restricts the uses and disclosures of your PHI. You have the right to request that Central Huron Ambulance Services restrict now Central Huron Ambulance Services uses and discloses your medical information that Central Huron Ambulance Services has about you. Central Huron Ambulance Services is not required to agree to any restrictions you request, but any restrictions agreed to by Central Huron Ambulance Services in writing are binding on Central Huron Ambulance Services.

Internet, Electronic Mall, and the Right to Obtain Copy of Paper Notice on Request. If Central Huron Ambulance Services maintains a web site, Central Huron Ambulance Services will prominently post a copy of this Notice on Central Huron Ambulance Services web site.

Revisions to the Notice. Central Huron Ambulance Services reserves the right to change the terms of this Notice at any time, and the changes will be effective immediately and will apply to a” Protected Health Information that Central Huron Ambulance Services maintains. Any material changes to the Notice wi” be promptly posted in Central Huron Ambulance Services facilities and posted to Central Huron Ambulance Services web site, if Central Huron Ambulance Services maintains one. You can get a copy of the latest version of this Notice by contacting Central Huron Ambulance Services Privacy Officer.

Your Legal Rights and Complaints: 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 U S 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, please put your complaint in writing and address it to Central Huron Ambulance Services 291 E. Soper Road Bad Axe, MI 48413 or contact us via phone 989-269-7572