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.
Bar Harbor Fire Department (BHFD) 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. BHFD is also required to abide by
the terms of the version of this Notice currently in effect.
Uses
and Disclosures of PHI: BHFD may use PHI for the purposes 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 your 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 to you. We may give
your PHI to other health care providers involved in your treatment, 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 the services we provide to you,
including such things as submitting bills
to insurance companies, making medical necessity determinations, and collecting
outstanding accounts.
For healthcare 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. BHFD is permitted to use PHI without your written
authorization, or opportunity to object, in certain situations, and unless
prohibited by a more 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 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 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 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 if we deny
you access and let you know your appeal rights.
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 privacy officer.
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 your request to amend
your medical information only in certain circumstances, 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 that we have about you, please contact our
privacy officer.
The
right to request an accounting. You may request an accounting from us of certain disclosures of your
medical information that we have made in the 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 care 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, please contact our privacy
officer.
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. BHFD is
not required to agree to any restrictions you request, but any restrictions
agreed to by BHFD in writing are binding on BHFD.
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. BHFD
reserves the right to change the terms 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 facilities and on our web site, if we maintain one. You
can get a copy of the latest version of this Notice by contacting out privacy
officer.
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 to may direct all inquiries to our privacy officer.
Privacy Officer Contact
Information
Privacy Officer
Phone: 207-288-5554
Effective Date of
Notice: