NOTICE OF PRIVACY PRACTICES
Effective Date: 2 June 2015
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.
If you have any questions about this notice, please contact our Compliance Officer at (816) 283-9710.
WHO MUST FOLLOW THIS NOTICE?
This notice describes the privacy practices of LifeFlight Eagle and all employees that make up an affiliated covered entity.
We are required by law to:
Maintain the privacy of protected health information;
Give you this notice of our legal duties and privacy practices regarding health information about you; and
Follow the terms of our notice that is currently in effect.
HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION:
We need certain information to care for you. We also need information so we can receive payment for services. We will use and disclose your information in the ways described below. We have listed some of the uses and disclosures in the categories to provide an example within each category. We did not list all the uses and disclosures in each category.
We may use and disclose your information to provide, coordinate or manage your care. We may disclose Health Information to hospital personnel, doctors, nurses, technicians, EMS and/or public service personnel, or other personnel, including people outside our service who may be or had been involved in your medical care related to this event resulting in the provision of our services. For example, we may tell your primary physician about the care we provided you or give Health Information to a specialist to provide you with additional services.
We may use and disclose your information for payment of the services and treatment provided to you. For example, we use your information so that we or others may bill or receive payment from you, anyone who agrees to pay on your behalf, an insurance company or a third party for the treatment and services you received. We also may tell your health plan about a treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment.
Health Care Operations
We may use and disclose your information for health care operations purposes. Healthcare operations include quality improvement and educational, business planning and compliance activities. For example, we may use Health Information to review the treatment and services we provide, and we may disclose Health Information with other health care agencies that provided services to you to ensure that the care you receive is of the highest quality.
You have the opportunity to object to the following uses and disclosures of your information:
Individuals Involved in Your Care or Payment for Your Care
Unless you object, we may release medical information about you to a person who is involved in your medical care or helps pay for your care, such as a family member, other relative or any other person identified by you. We also use your information to notify family member, or another person responsible for your care, of your location, general condition, or death or disclose such information to an entity assisting in a disaster relief effort.
We may disclose your information to public or private agencies for disaster relief purposes.
We may also use and disclose your medical information for:
We may disclose your medical information to third parties we contract with to perform services on our behalf. For example, we may use another company to perform billing services on our behalf. All of our business associates are obligated, under contract with us, to protect the privacy of your information and are not allowed to use or disclose any information other than as specified in our contract.
We may use your information to identify you for a media story. If identified, you will be contacted to ask if you would like to participate. Your information will not be shared with the media without your written authorization.
To You or Your Personal Representative. We will disclose Health Information to you or a person that you designate as your personal representative or to a person that is designated by law such as parent or guardian. Such disclosure will be made upon a written request to a Privacy Officer.
We may also disclose your medical information to outside parties without your authorization in the following circumstances:
As Required by Law
We will disclose Health Information when required to do so by international, federal, state or local law.
To Avert a Serious Threat to Health or Safety
We may use and disclose your medical information when we believe it is necessary to prevent or lessen a serious threat to your health and safety or the health and safety of the public or another person.
Organ and Tissue Donation
If you are an organ donor, we may disclose your medical Health information to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank, as necessary, to facilitate organ or tissue donation and transplantation.
Specified Government Functions
In certain circumstances, federal law authorizes government agencies to use or disclose your medical information to facilitate specified government functions relating to the military and veterans, national security and intelligence activities and protective services for the president or others. Workers’ Compensation
We may disclose your medical information to comply with workers’ compensation laws.
Public Health Purposes
We may disclose your medical information for public health activities.
• Preventing or controlling disease, injury or disability
• Reporting births and deaths
• Reporting child abuse or neglect;
• Notifying a person who may be at risk for contracting or spreading a disease or condition.
Health Oversight Activities
We may disclose your medical information to a health oversight agency for activities authorized by law. These oversight activities might include audits, investigations, inspections and licensure. For example, we may disclose your information during a survey by a licensing agency.
We may disclose your medical information in response to a court or administrative order. We may disclose your medical information in response to a subpoena, or other lawful process, if you provide us with your authorization or we are required by law.
We may release medical information if asked to do so by a law enforcement official, if the disclosure is:
• Required by law
• To identify or locate a suspect, fugitive, material witness, or missing person
• About the victim of a crime if, under certain limited circumstances
• About a death we believe may be the result of criminal conduct
• About criminal conduct on our premises
• In emergency circumstances to report a crime, the location of the crime or victims, or the identity, description, or location of the person who committed the crime.
Coroners, Medical Examiners and Funeral Directors
In certain circumstance, we may disclose your medical information to a coroner or medical examiner. For example, to identify a deceased person or determine the cause of death. We may also release medical information about patients to funeral directors as necessary to carry out their duties.
We may use and disclose your medical information for research purposes. For example, a research project may involve comparing the health and recovery of all patients who received one medication or treatment to those who received another, for the same condition. We may use and disclose your information without your written authorization if this use or disclosure has been approved through an independent research approval process. We may also disclose to researchers preparing to conduct research.
If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may disclose your medical information to the appropriate correctional institution or law enforcement official. This disclosure would be necessary: (1) for the institution to provide you with healthcare; (2) to protect your health and safety or the health and safety of others; or (3) for the safety and security of the correctional institution.
Other uses of Medical Information
Other uses and disclosures of medical information not covered by this notice or the laws that apply to us will be made only with your written authorization. If you provide us with your authorization to use or disclose your medical information, you may revoke your authorization, in writing, at any time. If you revoke your authorization, we will no longer use or disclose medical information about you for the reasons covered by your authorization. You understand that we are unable to take back any disclosures we have already made under the authorization.
You have the following rights regarding medical information we maintain about you:
Right to Request Restrictions
You have the right to request a restriction or limitation of your medical information we use or disclose for treatment, payment, or health care operations. In addition, you have the right to request a limit on the medical information we disclose about you to someone who is involved in your care or the payment for your care. We are not required to agree to your request except if you have paid for the services out of pocket in full and you request that we not submit your information to your health plan. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment.
To request a restriction of the use or disclosure of your information, contact our Compliance Officer to obtain the form to make your request.
Right to Request Confidential Communications
You have the right to request that we communicate with you or your responsible party about your healthcare in an alternative way or at a certain location. We will not ask you for the reasoning you’re your request but may ask for clarification. We will accommodate your request, if it is reasonably within our means to do so. You may be required to make alternative payment arrangements. To request confidential communications, contact our Compliance Officer to obtain the form to make your request.
Right to Inspect and Copy
You have the right to inspect and copy medical information contained in a designated record set for as long as we retain the protected health information. A “designated record set” contains medical and billing records and any other records our organization uses for making decisions about you. We may charge a fee for the costs of copying, mailing or other supplies associated with your request. To request or to inspect or copy your records, contact our Compliance Officer to obtain the form to make your request. We may deny your request where required by law. If you are denied access, you may request that the denial be reviewed, and we will comply with the outcome of the review.
Right to Amend
You have the right to ask us to amend your medical and/or billing information that you feel is incorrect or incomplete for as long as the information is kept by us. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:
• Was not created by us, unless the person or entity that created the information is no longer available to make the amendment
• Is not part of the medical information kept by us
• Is not part of the information which you would be permitted to inspect or copy
• Is not accurate or complete.
To request an amendment to your record, contact our Compliance Officer to obtain the form to make your request.
Right to an Accounting of Disclosures
You have the right to request an accounting of disclosures, a list of individuals and entities that have received your medical information. This list will not include an accounting of disclosures for treatment, payment, and heath care operations, disclosures pursuant to authorization, incidental disclosures, disclosures for notification purposes, disaster relief purposes and the persons involved in your care; disclosures for national security or intelligence purposes, disclosures to correctional institutions or law enforcement officials having custody of you.
You may receive one free accounting during a twelve-month period. If you request more than one accounting, you will be charged a fee. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.
To request an accounting disclosure, contact our Compliance Officer to obtain the form to make your request. Your request must state a time period: which may not be longer than six years.
Right to a Paper Copy of This Notice
You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice.
You may obtain a copy of this notice at our Web site at www.lifeflighteagle.org
To obtain a paper copy of this notice write to our Compliance Officer. At the following address:
Attn: Compliance Officer
500 NW Richards Road
Kansas City, MO 64116
CHANGES TO THIS NOTICE
We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for medical information we already have as well as any information we receive in the future. We will post a copy of the current notice on our website. The notice will contain the effective date on the first page, in the top right-hand corner.
If you believe your privacy rights have been violated, you may file a complaint with LifeFlight Eagle or the Secretary of the Department of Health and Human Services. To file a complaint with us, contact our Compliance Officer to obtain the form to file your complaint.
You will not be penalized in any way for filing a complaint.
All correspondence and requests should be forward to our Compliance Officer at the following address:
Attn: Compliance Officer
500 NW Richards Road
Kansas City, MO 64116