Notice of Privacy Practices

South East Ambulance District

Important

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.

Purpose of This Notice

This notice describes your legal rights, advises you of our privacy practices, and explains how South East Ambulance District EMS is permitted to use and disclose your protected health information (PHI).

Our Responsibilities

We are required by law to maintain the privacy and security of your PHI; notify you promptly if a breach occurs and describe information that may have been compromised; follow the duties and practices outlined in this notice; provide a copy electronically or on paper; and post this notice on our website. We will not use or share information beyond what is described here unless you authorize it in writing. You may withdraw that authorization in writing at any time.

Uses and Disclosures Without Your Authorization

Treatment

We use verbal and written medical information to assess your condition and provide treatment. We may share information with other healthcare professionals involved in your care, including through radio or telephone reports to hospitals or dispatch centers, and through records created during treatment and transport.

Payment

We may organize PHI, submit bills directly or through a third-party billing company, manage claims, determine medical necessity, perform utilization reviews, and collect outstanding accounts.

Healthcare Operations

We may use PHI for quality assurance, licensing, training, legal and financial services, business planning, handling grievances and complaints, de-identified reporting, and accreditation reviews.

Fundraising

We may contact you for fundraising. You may request that we stop contacting you for fundraising purposes.

Information About Other Services

We may contact you about healthcare-related services, including SourcePoint referrals, transport services, and healthcare-related benefits.

Other Permitted Uses and Disclosures

We may disclose PHI as permitted or required by law for: another healthcare provider’s treatment or payment activities; fraud and abuse detection and legal compliance; public health reporting or investigations, including births, deaths, disease, abuse, neglect, domestic violence, product defects, and communicable disease exposure; healthcare oversight, audits, investigations, inspections, disciplinary proceedings, and other government actions; military, national defense, security, and specialized government functions; preventing serious threats to health or safety; workers’ compensation; and coroners, medical examiners, and funeral directors carrying out authorized duties.

Law Enforcement

Disclosures may be made in circumstances permitted or required by law, including pursuant to warrants; identifying or locating certain persons; crimes occurring during a response; treatment of crime victims; required reports such as gunshot wounds, stabbings, neglect, or abuse; preventing harm; or reporting a patient’s destination.

Judicial and Administrative Proceedings

Disclosures may be made pursuant to court orders, administrative orders, subpoenas, or other legal processes as permitted by law.

Family, Friends, and Others Involved in Care

We may share relevant information with family members, relatives, close friends, or others involved in your care when you agree, have an opportunity to object and do not object, or when the circumstances reasonably indicate you would not object. If you cannot object, we may use professional judgment to determine whether a limited disclosure is in your best interest.

Uses and Disclosures Requiring Written Authorization

Other uses or disclosures generally require your written authorization specifying the information and intended use or disclosure. Written authorization is required for certain uses or disclosures of psychotherapy notes, marketing communications involving payment, and the sale of PHI, subject to applicable exceptions. You may revoke authorization in writing, except where we have already relied on it.

Your Rights Regarding PHI

Access, Inspect, or Copy

You may request access to and copies of most medical information we maintain about you. Submit written requests to the SEAD HIPAA Compliance Officer. We generally provide access within 30 days, subject to lawful extensions and exceptions. If access is denied, we will explain the reason and applicable review rights in writing. If records are electronic, you may request an electronic copy. You may request transmission to another designated person in a signed written request identifying the recipient and destination. Reasonable cost-based fees may apply, subject to applicable law.

Request an Amendment

You may request a correction to your PHI in writing using a form available from the SEAD HIPAA Compliance Officer. We generally act on amendment requests within 60 days, subject to lawful extensions. We may deny a request in circumstances allowed by law and will explain your rights.

Accounting of Disclosures

You may request an accounting of certain disclosures made during the preceding six years. Certain disclosures are excluded, including many made for treatment, payment, healthcare operations, disclosures you authorized, disclosures to you or certain persons involved in your care, and certain government or law-enforcement disclosures.

Request Restrictions

You may request restrictions on uses and disclosures for treatment, payment, or operations, or on sharing information with family and others involved in care. We are not generally required to agree, except as required by law. In particular, we must honor a qualifying request not to disclose information to a health plan for a service you or your representative paid for in full out of pocket, when applicable legal conditions are met. Agreed restrictions may be terminated under circumstances allowed by law.

Confidential Communications

You may request in writing that we contact you at an alternative location or by an alternative method. We will accommodate reasonable requests as required by law. Please specify the preferred address, location, or method in your request.

Notice of a Breach

If a reportable breach of unsecured PHI occurs, we will notify affected individuals as required by law, generally without unreasonable delay and no later than 60 days after discovery. Notice may be mailed to your last known address or sent electronically if you have agreed to electronic notice.

Obtain a Copy of This Notice

You may request an electronic or paper copy of the current Notice of Privacy Practices. The current version will also be posted on our website.

Notice Revisions

South East Ambulance District follows the current Notice of Privacy Practices and reserves the right to revise it. Changes may apply to PHI we already maintain and will be made available on our website and in district facilities. You may request the current notice from the SEAD HIPAA Compliance Officer.

Complaints and Legal Rights

If you believe your privacy rights have been violated, you may file a complaint with the South East Ambulance District HIPAA Compliance Officer or with the U.S. Department of Health and Human Services Office for Civil Rights. You will not be retaliated against for filing a complaint.

U.S. Department of Health and Human Services, Office for Civil Rights
200 Independence Avenue SW
Washington, DC 20201
1-877-696-6775
File a complaint with HHS

Contact the SEAD HIPAA Compliance Officer

South East Ambulance District
1968 Mermill Road
Bradner, OH 43406

For privacy requests or questions, contact the district and ask for the HIPAA Compliance Officer.