Oakhurst Emergency Medical Services
72 Larkin Pl.
Oakhurst, NJ 07755
NOTICE OF PRIVACY PRACTICES: Effective Aug 24, 2016
THIS NOTICE DESCRIBES HOW YOUR MEDICAL INFORMATION MAY BE USED, DISCLOSED, AND HOW YOU MAY GAIN ACCESS TO THIS INFORMATION. PLEASE READ CAREFULLY.
OUR OBLIGATIONS BY LAW.
- Maintain the privacy of protected health information.
- Provide each patient (or patient's person of importance) with this notice of our legal duties & privacy practices regarding health information.
- Follow the terms of this notice.
HOW WE MAY USE & DISCLOSE HEALTH INFORMATION:
The following categories describe the ways we may use and disclose health information that identifies you. Some of the categories include examples, though every type of use or disclosure of health information in a category is not listed. In addition to the purposes described below, we may use or disclose health information for a purpose not stated in this notice. At any time, you may revoke permission by sending written notification of revocation to the address and contact information listed at the top of this notice.
Treatment:
Oakhurst EMS may use health information to treat or provide you with healthcare services. Oakhurst EMS may disclose your health information to paramedics, doctors, nurses, or other health personnel who may be involved in your medical care. Example: Your health information may be reported to Emergency Department staff (doctors, nurses, etc.), as well as specialists who assist with providing additional medical services.
Payment:
Oakhurst EMS may use and disclose health information so we, or a billing agency on our behalf. Oakhurst EMS may bill and receive payment from you, insurance providers, or a third party, for the treatment and services you received. Example: Oakhurst EMS may release your health information to insurance providers about your treatment so payment may be made for such treatments. Oakhurst EMS may also provide your health insurance carrier with services you are going to receive to obtain prior approval or to determine whether your insurance plan will cover the treatment.
Healthcare Operations:
Oakhurst EMS may use health information for healthcare operational purposes. These uses and disclosures are necessary to monitor the quality of care that is provided to our patients, as well as operation and management purposes. Example: Health information may be reviewed to analyze response times, types of services provided, as well as quality improvements.
Individuals Involved in Your Care or Payment for Your Care:
Oakhurst EMS may release health information to a person who is involved with your medical care or is helping to pay for your treatment, such as a family member or friend. Oakhurst EMS may also notify your family about your location or general condition. Additionally, Oakhurst EMS may disclose such information to an entity assisting in a disaster relief effort.
Research:
Under certain circumstances, Oakhurst EMS may release health information for research purposes. Example: A research project may involve comparing the health and recovery of all patients who receive one medication or treatment to those who receive another for the same condition. Before Oakhurst EMS discloses health information for research, the proposed project will go through a stringent review procedure. This process is to compare the benefits of the proposed research to the necessities for privacy. Even without special approval, Oakhurst EMS may permit researchers to review records to assist them with identifying patients who may be included in their research project for other similar purposes so long as they do not remove or take copies of any health information.
SPECIAL CIRCUMSTANCES:
Required by Law:
When required to do so by international, federal, state, and/or local law, Oakhurst EMS will disclose health information.
To Avert a Serious Threat to Health or Safety:
Oakhurst EMS may disclose health information, when necessary, to prevent or lessen a serious threat to your health and safety, or the health and safety of another person or the public. Disclosure of information will be made to a person or agency that may be in a position to prevent the threat.
Business Associates:
Oakhurst EMS may disclose health information to others who perform functions on behalf of or provide Oakhurst EMS with services if the information is necessary for such function or services. Example: Oakhurst EMS may utilize another company to perform collection services on their behalf. All Oakhurst EMS business associates are obligated under a contract with Oakhurst EMS to protect the privacy of your information and are not allowed to use or disclose any information other than as specified in their contract.
Organ and Tissue Donation:
If you are an organ donor, Oakhurst EMS may release health information to organizations, such as an organ donation bank, to facilitate the donation, procurement, or transplantation of organs, eye, and/or tissue.
Military and Veterans:
If you are a member of the US Armed Forces, Oakhurst EMS may release health information as required by military command authorities. Oakhurst EMS may also release health information to the appropriate military authority if you are a member of a foreign military.
Workers' Compensation:
Oakhurst EMS may release health information for workers' compensation or similar programs. These programs provide benefits for work-related injuries or illnesses.
Public Health Risk:
Oakhurst EMS may disclose health information for public health activities. These activities generally include disclosure to prevent or control disease, injury, or disability; report births and deaths; report child abuse or neglect; report reactions to medications or problems with products; notify people of recalls of products they may be using; track certain products and monitor their use and effectiveness; notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition; and conduct medical surveillance of the office in limited circumstances concerning workplace illness or injury. Oakhurst EMS may also release health information to an appropriate government authority if we believe a patient has been the victim of abuse, neglect, or domestic violence, however, this information will only be released if you agree, or we are required and/or authorized by law.
Health Oversight Activities:
Oakhurst EMS may release health information to a health oversight agency for actions authorized by law. These oversight activities include audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the healthcare system, government programs, and compliance with civil rights laws.
Lawsuits and Disputes:
If you are involved in a lawsuit or dispute, Oakhurst EMS may disclose health information in response to a court or administrative order. Oakhurst EMS also may disclose health information in response to a subpoena, discovery request, or other lawful processes by someone else involved in the dispute, but only if efforts have been made to notify you about the request or to obtain an order protecting the information requested.
Law Enforcement:
If requested by law enforcement officials, Oakhurst EMS may release health information for the following reasons:
- Response to a court order, subpoena, warrant, summons, or similar process.
- Limited information to identify or locate a suspect, fugitive, material witness, or missing person.
- Information about the victim of a crime if under limited circumstances and Oakhurst EMS is unable to obtain the person's agreement.
- A death we believe may be the result of criminal conduct.
- Emergency circumstances to report a crime, the location of the crime victim, or the identity, descriptions, and/or location of the person who committed the crime.
Coroners, Medical Examiners & Funeral Directors:
Oakhurst EMS may release health information to a coroner or medical examiner. This may be necessary to identify a deceased person or to determine the cause of death. If required for their duties, Oakhurst EMS may disclose health information to funeral directors.
National Security & Intelligence Activities:
Oakhurst EMS may release health information to authorized federal officials for intelligence, counter-intelligence, and other national security activities authorized by law.
Protective Services for the President & Others:
Oakhurst EMS may disclose health information to authorized federal officials so they may conduct special investigations or provide protection to the President, foreign heads of state, or other official dignitaries.
Inmates or Individuals in Custody:
If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release health information to the appropriate correctional institution or law enforcement official. This release would be made only if necessary:
- For the institution to provide you with healthcare.
- To protect your health and safety, or the health and safety of others.
- For the safety and security of the correctional institution.
YOUR RIGHTS:
You have the following rights regarding health information we maintain about you:
Right to Inspect and Copy:
You have the right to inspect and copy health information that may be used to make decisions about your care or payment for your care. To inspect and copy this health information, you must make a written request to Oakhurst Emergency Medical Services at 72 Larkin Pl. Oakhurst, NJ 07755.
Right to Amend:
If you feel that the health information we have is incorrect or incomplete, you have the right to request an amendment to the information. Such request must be made in writing to Oakhurst Emergency Medical Services at 72 Larkin Pl. Oakhurst, NJ 07755.
Right to Request Restrictions:
You have the right to request a restriction or limitation on health information we use or disclose for treatment, payment, or healthcare operations. In addition, you have the right to request a limit on the health information we disclose about you to someone who is involved in your care or the payment for your care. Example: You can request that Oakhurst EMS not share information about your care to your spouse. All requests must be made in writing to Oakhurst Emergency Medical Services at 72 Larkin Pl. Oakhurst, NJ 07755.
Right to Request Confidential Communications:
You have the right to request that Oakhurst EMS communicate with you about medical matters in specific forms or at specific locations. Example: You can request that you are only contacted by mail or at your work location. All requests for confidential communications must be made in writing to Oakhurst Emergency Medical Services at 72 Larkin Pl. Oakhurst, NJ 07755.
Changes to this Notice:
Oakhurst EMS reserves the right to make amend or revise this notice. Changes are effective for the health information Oakhurst EMS already has, as well as any information Oakhurst EMS receives in the future. Oakhurst EMS will post a copy of the current notice on it’s website OakhurstEMSinc.com. This notice will contain the effective date on the first page.
COMPLAINTS:
If you believe your privacy rights have been violated, you may file a complaint with Oakhurst EMS or the Secretary of the Department of Health and Human Services. To file a complaint against Oakhurst EMS, contact Oakhurst Emergency Medical Services at 72 Larkin Pl. Oakhurst, NJ 07755. All complaints must be made in writing. You will not be penalized for any complaints filed.
