NOTICE OF
PATIENT PRIVACY PRACTICES

Understanding Your PHI

Each time you call for an ambulance, we make a record of our treatment and care provided. This record includes who you are, where you live, your health problems and medications, the treatment and care we provide to you, and billing information.
     
 
Your Rights About PHI

 
 

Although we keep your PHI information, it belongs to you and you have the right to:

  1. Ask that Saxonburg VFC Ambulance tell you about your PHI in the way you like and place you want.
  2. Ask that we only use or tell others about your PHI so that we can take care of you, get paid, or manage our services.
  3. Request copies or look at your PHI, including the medical records, treatment, and billing records that we maintain. You must make this request in the form of a written request and we may charge a fee for copies.
  4. Request changes to your PHI if you think it's wrong or not complete. We may not make the change if we think your PHI is accurate and complete or if the requested change is not about your PHI or is about PHI that we did not create. We will not charge a fee for changes to PHI.
  5. Ask for disclosures of your PHI. This is a list of whom Saxonburg VFC Ambulance told you PHI to and what we told them. This list will not include disclosures made during routine treatment or care, billing, or our business management. You must make this request in a form of a written request and we may charge a fee for the list.
  6. File a complaint if you think your privacy rights have not been followed.
  7. Give authorization for other uses and disclosures. You may take back any authorizations at any time. You may also authorize us to provide PHI to others you wish to have the information. This authorization must be in writing.
 
 
Disclosure of PHI

 
 

Saxonburg VFC Ambulance will use and disclose your PHI in these ways:

  1. Treatment. We will use your PHI to take care of you and provide information to the hospital or doctor that will provide treatment beyond our care and transport.
  2. Payment. We will use and disclose your PHI in order to bill your insurance company and get paid for the services and supplies we use during your care and/or transport.
  3. Operations. We will use and disclose your PHI in order to manage our operations including quality review, infection or disease control, cost management, and business planning.
  4. Disclosures Required by Law. We will disclose your PHI when required to do so by federal, state, or local law.
  5. Law Enforcement. We may disclose PHI if asked to do so by a law enforcement official regarding a crime or criminal behavior; a warrant, summons, court order, subpoena, or similar legal process; to identify a suspect, witness, fugitive, or missing person; or in an emergency to report a crime or help in an investigation.
  6. Serious Threats to Health or Safety. We may use and/or disclose your PHI when necessary to reduce or prevent a serious threat to your health and safety or the health and safety of another individual or the public. Under these conditions, we will only tell your PHI to the person or organization able to help prevent the threat.
  7. Education. We may use and disclose certain portions of your PHI in the course of training our medical staff to improve their knowledge and abilities as pre-hospital providers.

 
 
For More Information or to Report a Problem

 
  If you have a question or want more information, you may contact us at Saxonburg VFC Ambulance, P.O. Box 530, Saxonburg, PA 16056, (724) 352-3300.