Piedmont Emergency Rescue Squad, Inc.
Notice of Privacy Practices Regarding Protected Health Information

This Notice Describes How Medical Information About You May Be Used And
Disclosed. Please Review It Carefully.

Piedmont Emergency Rescue Squad, Inc. provides medical transportation and
related services.  Due to the nature of these services, we are required by law to
maintain the privacy of certain confidential health care information, known as
Protected Health Information (PHI), and to provide you with a notice of our legal
duties and privacy practices with respect to your PHI.

Uses and Disclosures of PHI: We 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 obtaining verbal and written information about your
medical condition and treatment from you as well as from others (doctors, nurses,
etc.) who give orders to allow us to provide treatment to you.  We may give your
PHI to other health care providers involved in your treatment and may transfer
your PHI by radio or telephone to the hospital.
For Payment - This includes any means that we must undertake in order to get
reimbursed for the services we provide to you, including, submitting bills to
insurance companies, making medical necessity determinations, and collecting
outstanding accounts.
For Health Care Operations - This includes activities and training programs to
ensure that our personnel meet our standards of care and follow established
policies and procedures.
Reminders for Scheduled Transports - We may also contact you with a reminder
of any scheduled appointments for non-emergency ambulance transportation.

Use and Disclosure of PHI Without Your Authorization – We are permitted to use
PHI without your written authorization, or opportunity to object, in certain
situations, including:
-        For treatment, payment of health care operations activities of another health
care provider who treats you;
-        For health care and legal compliance activities;
-        To a family member or relative, or other individual involved in your care if
we obtain your verbal agreement to do so or you do not raise an objection to such
disclosure when asked, and in certain circumstances where we are unable to obtain
your agreement and believe the disclosure is in your best interest;
-        To a public health authority in certain situations as required by law (such as
to report abuse, neglect, domestic violence, etc.);
-        For health oversight activities including audits or government investigations,
inspections, disciplinary proceedings, etc. undertaken by the government by law to
oversee the health care system;
-        For judicial 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 workers’ compensation purposes to comply 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.

Any other use of disclosure of PHI will only by made with your written
authorization. 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 regarding your PHI,
including:
The Right To Inspect and Copy Your Information: You may review and copy your
medical records and information.  You should make such a request to us at P.O.
Box 333, Piedmont, AL  36272.  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 may deny your request if it is not
written or if you fail to state a reason for the proposed amendment. We may also
deny your request if you ask us to amend information that is not part of the
information we keep, was not created by us, is not part of the information available
for you to inspect and copy, or is accurate and complete.
The Right To Request an Accounting: You may request an accounting from us of
certain disclosures of your medical information we have made in the six years prior
to the date of your request. However, your requests for an accounting of
disclosures cannot precede the implementation date of HIPAA – April 14th, 2003.
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 a medical facility from/to which we have
transported you. We are also not required to give you an accounting of our uses of
PHI for which you have not already given us written authorization. If you wish to
request an accounting, contact our local privacy official.
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. We are not required to agree to any restrictions you request,
but any restrictions agreed to by us in writing are binding on us.
Revisions to the Notice: We reserve the right to change the terms of this Notice at
any time, and the changes will be effective immediately and will apply to all PHI we
maintain. Any material changes to the Notice will be promptly posted at our facility.
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. Direct all
inquiries to our privacy official.


Privacy Official Contact Information:
Jim Blackstone
800.905.8099


Effective Date of Notice:  April 14th, 2003
Piedmont Rescue
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Piedmont Rescue Privacy Notice
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