NOTICE of PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Medex Transportation Inc. is required by law to maintain the privacy of certain confidential health care information, known as Protected Health Information or PHI, and to provide you with a notice of your legal duties and privacy practices with respect to your PHI. Medex Transportation Inc. is also required to abide by the term of the version of this Notice currently in effect.
Uses and Disclosures of PHI: Medex Transportation Inc. 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 you medical condition and treatment from you as well as from others, such as doctors and nurses who give orders to allow us to provide treatment t you. We may give your PHI to other health care provides involved in your treatment, and may transfer you PHI via radio or telephone to the hospital or dispatch center.
For Payment. This includes any activities we must undertake in order to get reimbursed for the services we provide to you, including such things as submitting bills to insurance companies, making medical necessity determinations and 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. We 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 provide.
Use and Disclosure of PHI Without Your Authorization. Medex Transportation Inc. is permitted to use PHI without your written authorization, or opportunity to object, in certain situations, and unless prohibited by a stringent state law, including:
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 we have 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. We will normally provide you with access to this information within 30 days of your request. We may also charge you a reasonable fee for you to copy any medical information that you have right to access. In limited circumstances, we may deny your access to your medical information, and you may appeal certain types of denials. We have available forms to request access to your PHI and we will provide a written response if we deny your access and let you know you appeal right, 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 office.
The right to amend your PHI. You have the right to ask us to amend written medical information that we may have about you. We will generally amend your information within 60 days of your request and will notify you when we have amended the information. We are permitted by law to deny you request to amend your medical information only in certain circumstance, like when we believe the information you have asked us to amend is correct. If you wish to request that we amend the medical information we have about you, you should contact our office.
The right to request an accounting. You may request an accounting from us of certain disclosure of your medical information that we have made in prior to the date of your request. 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 our business associates, like our billing company or a medical facility from/to which we have transported you. We are also not required to give you an accounting of our uses of Protected Health Information for which you have already given us written authorization. If you wish to request an accounting, contact our office.
The right to request that we restrict the uses and disclosures of you PHI. You have the right to request that we restrict how we use and disclose you medical information that we have about you. Medex Transportation Inc. is not required to agree to any restrictions you request, but any restrictions agreed to by Medex Transportation Inc. in writing are binding on Medex Transportation Inc.
Internet, Electronic Mail, and the Right to Obtain Copy of Paper Notice on Request. If we maintain a web site, we will prominently post a copy of this Notice on our web site. If you allow us, we will forward you this Notice by electronic mail instead of on paper and you may always request a paper copy of the Notice.
Revisions to the Notice: Medex Transportation Inc. reserves the right to change the term of this Notice at any time, and the 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 office and posted to our web site, if we maintain one. You can get a copy of the latest version of this Notice by contacting our office.
You Legal Rights and Complaints: You also have the right to complaint to us, or to the New Jersey Department of Health and Senior 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 state. Should you have any questions, comments or complaints you may direct all inquiries to our office.
Medex Transportation Inc.
660 Tennent Road Suite 206
Manalapan NJ 07726
Effective Date of Notice: February 1, 2008