Patient Notice

Patient Privacy Notice

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.

The North Brunswick First Aid and Rescue Squad, 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 our legal duties and privacy practices with respect to your PHI.

North Brunswick First Aid and Rescue Squad, 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: North Brunswick First Aid and Rescue Squad, Inc. can use your information for treatment pertaining to your medical condition and treatment provided to you by us and other medical personnel. It also includes information we give to other health care personnel to whom we transfer your care and treatment. We may also disclose your condition to family or care givers who are involved in your medical care, and may transfer your 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 these services we provide to you, including such things as organizing your PHI and submitting bills to insurance companies (either directly or through a third party billing company) management of billed claims for services rendered, medical necessity determinations and reviews, utilization review, and collection 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.

FOR 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 nonemergency ambulance and medical transportation, or to inform you about other services we provide.

USE AND DISCLOSURE OF PHI WITHOUT YOUR AUTHORIZATION: North Brunswick First Aid and Rescue Squad, Inc. is permitted to use PHI without your written authorization, or opportunity to object in certain situations, including:

  • For treating you or in obtaining payment for services provided to you or in other health care operations;
  • For treatment activities of another health care provider;
  • To another health care provider or entity for the payment activities of the provider or entity that receives the information (such as the hospital or your insurance carrier).
  • To another health care provider (such as hospital to which you are transported) for the health care operations activities of the entity that receives the information as long as the entity receiving the information has or has had a relationship with you and the PHI pertains to that relationship;
  • For health care fraud and abuse detection or for activities related to compliance with the law;
  • To a family member, other relative, or close personal friend or other individual involved in your care if we obtain your verbal agreement to do so or if we give you an opportunity to object to such a disclosure and you do not raise an objection, and in certain other circumstances where we are unable to obtain your agreement and believe the disclosure is on your best interests. For example, we may assume you agree to your disclosure of your personal health information to your spouse when your spouse called the ambulance for you;
  • To a public health authority in certain situations (such as reporting a birth, death, or disease as required by law, as part of a public health investigation, to report child or adult abuse or neglect or domestic violence, to report adverse events such as product defects, or to notify a person about exposure to a possible communicable disease as required by law;
  • For health oversight activities including audits or government investigations, inspections, disciplinary proceedings, and other administrative or 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 there is a warrant for the request, or when the information is needed to locate a suspect or stop crime;
  • 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, we may release health information 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 search projects, but this will be subject to strict oversight and approvals;
  • We may use or disclose health information about you in a way that does not personally identify you or reveal who you are.

Any other use of 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 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 the protection of your PHI, including:

The right to access copy or inspect your PHI: This means you may come to our office and 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 the right to access. In limited circumstances, we may deny you 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.

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 your medical information only in certain circumstances, such as when we believe the information you have asked us to amend is correct. If you wish to request that we amend the medical information that we have about you, you should contact the privacy officer listed at the end of this Notice.

The right to request an accounting of our use and disclosure of your PHI: You may request an accounting from us of certain disclosures of your medical information that we have made in the last six years 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 of the medical information about you that we have used or disclosed that is not exempted from the accounting requirement, you should contact the privacy officer listed at the end of this Notice.

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 that we have about you for treatment, payment or health care operations, or to restrict the information that is provided to family, friends and other individuals involved in your health care. You do have the right to make payment in full to restrict disclosure of PHI to a health plan. North Brunswick First Aid and Rescue Squad is prohibited from the sale of PHI or disclosures for marketing / fund raising activity without written authorizations from the patient. North Brunswick First Aid and Rescue Squad, Inc. is not required to agree to any restrictions you request, but any restrictions agreed to by North Brunswick First Aid and Rescue Squad, Inc. are binding on us.

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: North Brunswick First Aid and Rescue Squad, Inc. reserves the right to change the terms of the 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 facilities and posted to our web site, if we maintain one. You can get a copy of the latest version of this Notice by contacting the Privacy Officer identified below.

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. Should you have any questions, comments or complaints, you may direct all inquiries to the privacy officer listed at the end of this Notice. Individuals will not be retaliated against for filing a complaint.

Privacy/Compliance Officer

Lisa Grande
Administrator
North Brunswick First Aid and Rescue Squad, Inc.
P.O. Box 7043
880 Ridgewood Avenue
North Brunswick, NJ 08902-7043
www.nbfars.org