Notice of Privacy Practices

OUR OBLIGATIONS:

We are required by law to:

- Maintain the privacy of your protected health information (PHI);

- Give you this Notice of our legal duties and privacy practices regarding your PHI; and

- Follow the terms of our Notice that is currently in effect.

HOW MAY USE AND DISCLOSE PHI:

The following categories describe ways that we may use and disclose your PHI. Some of the categories include examples, but every type of use or disclosure of your PHI in a category is not listed. Except for the purposes described below, we will use and disclose your PHI only with your written permission. If you give us permission to use or disclose your PHI for a purpose not discussed in this Notice, you may revoke that per- mission, in writing, at any time.

For Treatment. We may use your PHI to treat you or provide you with health care services. We may disclose your PHI to doctors, nurses, technicians, or other personnel, including people outside our facility who may be involved in your medical care. For example, we may tell your primary physician about the care we provided you or give Health Information to a specialist to provide you with additional services.

For Payment. We may use and disclose your PHI so that we or others may bill or receive payment from you, an insurance company or a third party for the treatment and services you received. For example, we may give your health plan information about your treatment so that they will pay for such treatment. We also may tell your health plan about a treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment.

For Health Care Operations. We may use and disclose your PHI for health care operations purposes. These uses and disclosures are necessary to make sure that all of our patients receive quality care and for our operation and management purposes. For example, we may use your PHI to review the treatment and services we provide to ensure that the care you receive is of the highest quality.

Fundraising Activities. We may use your PHI to contact you in an effort to raise money. We may disclose your PHI to a related foundation or to our business associate so that they may contact you to raise money for us.

Individuals Involved in Your Care or Payment for Your Care. We may release your PHI to a person who is involved in your medical care or helps pay for your care, such as a family member or friend. We also may notify your family about your location or general condition or disclose such information to an entity assisting in a disaster relief effort.

Research. Under certain circumstances, we may use and disclose your PHI for research purposes. For example, a research project may involve comparing the health and recovery of all patients who receive one medication or treatment to those who received another, for the same condition. Before we use or disclose Health Information for research, though, the project will go through a special approval process. This process evaluates a proposed research with the need for privacy of health information. Even without special approval we may permit researchers to look at records to help them identify patients who may be included in their research project or for other similar purposes, so long as they do not remove or take a copy of any of your PHI.

SPECIAL CIRCUMSTANCES

As Required By Law. We will disclose your PHI when required to do so by international, federal, state or local law.

To Avert a Serious Threat to Health or Safety. We may use and disclose your PHI when necessary to prevent or lessen a serious threat to your health and safety or the health and safety of the public or another person. Any disclosure, however, will be to someone who may be able to help prevent the threat.

Business Associates. We may disclose your PHI to our Business Associates that perform functions on our behalf or provide us with services if the information is necessary for such functions or services. For example, we may use another company to perform billing services on our behalf. All of our Business Associates are obligated, under contract with us, to protect the privacy of your PHI and are not allowed to use or disclose any information other than as specified in our contract.

Organ and Tissue Donation. If you are an organ donor, we may release your PHI to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank, as necessary, to facilitate organ or tissue donation and transplantation.

Military and Veterans. If you are a member of the armed forces, we may release your PHI as required by military command authorities. We also may release your PHI to the appropriate foreign military authority if you are a member of a foreign military.

Workers' Compensation. We may release your PHI for workers' compensation or similar programs. These programs provide benefits for work-related injuries or illness.

Public Health Risks. We may disclose your PHI for public health activities. These activities generally include disclosures to prevent or control disease, injury or disability; report births and deaths; report child abuse or neglect; report reactions to medications or problems with products; notify people of recalls of products they may be using; track certain products and monitor their use and effectiveness; notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition; and conduct medical surveillance of the hospital in certain limited circumstances concerning workplace illness or injury. We also may release your PHI to an appropriate government authority if we believe a patient has been the victim of abuse, neglect or domestic violence; however, we will only release this information if you agree or when we are required or authorized by law.

Health Oversight Activities. We may disclose Health Information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.

Lawsuits and Disputes. If you are involved in a lawsuit or a dispute, we may disclose your PHI in response to a court or administrative order. We also may disclose your PHI in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested. Law Enforcement. We may release PHI if asked by a law enforcement official for reasons such as: (1) in response to a court order, subpoena, warrant, summons or similar process; (2) limited information to identify or locate a suspect, fugitive, material witness, or missing person; (3) about a death we may believe may be the result of criminal conduct on our premises; and (4) in emergency circumstances, to report a crime, the location of the crime, or the identity, description, or location of the person who committed the crime.

Coroners, Medical Examiners and Funeral Directors. We may release your PHI to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We also may release your PHI to funeral directors as necessary for their duties.

National Security and Intelligence Activities. We may release your PHI to authorized federal officials for intelligence, counter-intelligence, and other national security activities authorized by law.

Protective Services for the President and Others. We may disclose your PHI to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state or conduct special investigations.

Inmates or Individuals in Custody. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release your PHI to the appropriate correctional institution or law enforcement official. This release would be made only if necessary (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) for the safety and security of the correctional institution.

YOUR RIGHTS:

You have the following rights regarding your PHI that we maintain:

Right to Inspect and Copy. You have the right to inspect and copy your PHI that may be used to make decisions about your care or payment for your care.

Right to Amend. If you believe that your PHI we have is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for us.

Right to an Accounting of Disclosures. You have the right to request an accounting of certain disclosures of your PHI that we made.

Right to Request Restrictions. You have the right to request a restriction or limitation on your PHI that we use or we disclose for treatment, payment, or health care operations. In addition you have the right to request a limit on the your PHI we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend. For example, you could ask that we not share information about your surgery with your spouse. We are not required to agree to your request. If we agree, we will comply with your request unless we need to use the information in certain emergency treatment situations.

Right to Request Confidential Communications. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we contact you only by mail or at work. To request confidential communications, you must make your request, in writing. Your request must specify how or where you wish to be contacted. We will accommodate reasonable requests.

Right to a Paper Copy of This Notice. You may ask us to give you a copy of this Notice at any time. Even if you have agreed to receive this Notice electronically, you are still entitled to a paper copy of this Notice.

CHANGES TO THIS NOTICE:

We reserve the right to change this Notice. We reserve the right to make the revised or changed Notice effective for any of your we already have as well as any information we receive in the future. We will post a copy of the current Notice on our web site at www.huntersamb.com The Notice will contain the effective date on the first page.

COMPLAINTS:

If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the Department of Health and Human Services. All complaints must be made in writing.

You will not be penalized for filing a complaint.

TO INQUIRE ABOUT THE USE AND DISCLOSURE OF YOUR PHI, TO EXERCISE YOUR RIGHTS ABOUT YOUR PHI, OR TO FILE A COMPLAINT, CONTACT:  

Privacy Officer
Hunter's Ambulance Service, Inc.
450 West Main Street
Meriden, CT 06451
Tel: (203) 514-5135