PHI Air Medical, L.L.C. Notice of Privacy Practices
THIS NOTICE OF PRIVACY PRACTICES (“NOTICE”) DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU (REFERRED TO AS “PROTECTED HEALTH INFORMATION” OR “PHI”) MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. PHI Air Medical, L.L.C. (also referred to herein as “we”, “us”, or “our”) is required by law to protect your PHI, to provide you with this Notice describing our legal duties and privacy practices, to follow the terms of this Notice, and to notify you of any breach of your unsecured PHI.
How We May Use and Disclose Your PHI. We may use and disclose your PHI without your authorization for the following purposes: Treatment, Payment, and Health Care Operations. We may use and disclose PHI (1) for your medical care, including disclosures to hospitals, physicians, and other persons who are involved in your care; (2) so that payment may be collected from you, your insurance company, or a third party for the transport services we provide; and (3) for medical transport operations, which include activities necessary to run the medical transport company and make sure that you receive quality care. Fundraising Activities. We may use your PHI to contact you in an effort to raise money for PHI Air Medical, L.L.C. (“provider”) and our operations. If you do not want us to contact you for fundraising efforts, you may opt out. Individuals Involved in Your Care or Payment for Your Care. We may disclose PHI to a family member or friend who is involved in your medical care or payment for your care. Health-Related Products and Services. We may use or disclose your PHI to tell you about health-related products or services, or to recommend possible treatment alternatives that may be of interest to you. Disaster Relief Efforts. We may disclose PHI to entities assisting in a disaster relief effort so that your family can be notified about your condition, status, and location. Research. We may use PHI to contact you to find out if you may be interested in participating in a particular research study. As Required By Law. We will disclose PHI when required to do so by federal, state, or local law. To Avert a Serious Threat to Health and Safety. We may use and disclose PHI, with some limitations, when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Organ & Tissue Donation. If you are a donor, we may release PHI to organ or tissue procurement organizations as necessary to facilitate organ or tissue donation and transplantation. Workers’ Compensation. We may release PHI to workers’ compensation programs or other similar programs. Public Health Disclosures. We may disclose PHI to public health agencies for preventing or controlling disease or injury, or reporting the abuse or neglect of children, elders, and dependent adults. Health Oversight Activities. We may disclose PHI to a health oversight agency for activities such as audits, investigations, inspections and licensure. Law Enforcement. We may disclose PHI under limited circumstances to a law enforcement official in response to a warrant or similar process; to identify or locate a suspect; or to provide information about the victim of a crime. Lawsuits and Disputes. We may disclose PHI in response to a court or administrative order, or a subpoena, discovery request, or other lawful process in certain circumstances. Coroners, Medical Examiners and Funeral Directors. We may disclose PHI to a coroner, medical examiner, or funeral director as necessary to carry out their duties. Specialized Government Functions. We may disclose PHI as required by military authorities or to authorized federal officials for national security and intelligence activities. Other Uses of Medical Information. Other uses and disclosures of PHI not covered in this Notice will be made only with your written permission. Uses and disclosures for marketing and disclosures that would be a sale of medical information require your written authorization. You may revoke a written authorization to disclose your information at any time and we will stop use and disclosure for the reasons covered in your written permission. You understand that we are unable to take back any disclosures that we may have already made with your permission, and that we are required to retain our records of the care that we provided to you.
Your Rights Regarding Your Medical Information. You have the right to inspect and copy your PHI, with certain exceptions. You have the right to request an amendment of your PHI if you believe your PHI is incorrect or incomplete. We may deny your request if you ask us to amend PHI that is accurate and complete, or is not part of the PHI kept by or for us. You have the right to an accounting of disclosures of your PHI that we have made, other than for treatment, payment or health care operations, and other exceptions permitted under federal law. You have the right to request that we follow special restrictions when using or disclosing your PHI for treatment, payment or health care operations. However, in most cases we are not required to agree to your request. We will agree to the requested restriction as required by law if: (a) the disclosure is for the purpose of carrying out payment or health care operations and is not otherwise required by law; and (b) the PHI pertains solely to a health care item or service for which you, or someone other than your health plan on your behalf, has paid us in full. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. We will accommodate all reasonable requests. The list may also exclude certain other disclosures, such as for national security purposes. You have the right to receive a paper copy of this Notice at any time upon written request. If you pay for a service or health care item out-of pocket and in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your PHI. We will make sure this person has this authority and can act for you before we take any action.
Breach of PHI. We will notify you if a reportable breach of your unsecured PHI is discovered. Notification will be made to you no later than 60 days from the date the breach is discovered, and will include a brief description of how the breach occurred, the PHI involved and contact information for you to ask questions.
Questions or Complaints. If you have any questions about this Notice, please contact us at the address on the accompanying page. If you believe your privacy rights have been violated, you may file a complaint with PHI Air Medical, L.L.C. by sending a letter to the HIPAA Privacy Official at 2800 N 44th Street, Suite 800 Phoenix Arizona 85008 or calling 602-224-3500 You may also file a complaint with the Secretary of the Department of Health and Human Services by sending a letter to 200 Independence Avenue, S.W., Washington D.C. 20201, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints. You will not be penalized for filing a complaint. Changes to This Notice. We reserve the right to change this Notice and make the revised Notice effective for PHI we already have about you as well as any PHI we receive in the future. If we change our Notice, you may see a copy of the revised Notice on the PHI Air Medical website http://www.phiairmedical.com.