Indianola Fire Dept
Notice of Privacy Practices
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.
Indianola Fire Department is committed to protecting your personal health
information. We are required by law to maintain the privacy of health
information that could reasonably be used to identify you, known as
“protected health information” or “PHI.” We are also required by law to
provide you with the attached detailed Notice of Privacy Practices (“Notice”)
explaining our legal duties and privacy practices with respect to your PHI.
We respect your privacy, and treat all health care information about our
patients with care under strict policies of confidentiality that all of our staff
our committed to following at all times.
PLEASE READ THE ATTACHED DETAILED NOTICE. IF YOU HAVE
ANY QUESTIONS ABOUT IT, PLEASE CONTACT Gregory M. Chia, OUR
HIPAA COMPLIANCE OFFICER, AT gchia@cityofindianola.com.
Detailed Notice of Privacy Practices
Purpose of This Notice: This Notice describes your legal rights, advises
you of our privacy practices, and lets you know how Indianola Fire
Department is permitted to use and disclose PHI about you.
Uses and Disclosures of Your PHI We Can Make Without Your
Authorization
Indianola Fire Department may use or disclose your PHI without your
authorization, or without providing you with an opportunity to object, for the
following purposes:
Uses and Disclosures of PHI: Indianola Fire Department 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:
Treatment. This includes such things as verbal and written information that
we obtain about you and use pertaining to your medical condition and
treatment provided to you by us and other medical personnel (including
doctors and nurses who give orders to allow us to provide treatment to
you). It also includes information we give to other health care personnel to
whom we transfer your care and treatment, and includes transfer of PHI via
radio or telephone to the hospital or dispatch center as well as providing
the hospital with a copy of the written record we create in the course of
providing you with treatment and transport.
Payment. This includes any activities we must undertake in order to get
reimbursed for the services we provide to you, including such things as
organizing your PHI and submitting bills to insurance companies (either
directly or through a third party billing company), management of billed
claims for services rendered, medical necessity determinations and
reviews, utilization review, and collection of outstanding accounts.
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, obtaining
legal and financial services, conducting business planning, processing
grievances and complaints, creating reports that do not individually identify
you for data collection purposes, fundraising, and certain marketing
activities.
Other Uses and Disclosure of Your PHI We Can Make Without
Authorization.
Indianola Fire Department is also permitted to use or disclose your PHI
without your written authorization in situations including:
For the treatment activities of another health care provider;
To another health care provider or entity for the payment
activities of the provider or entity that receives the
information (such as your hospital or insurance company);
To another health care provider (such as the hospital to
which you are transported) for the health care operations
activities of the entity that receives the information as long as
the entity receiving the information has or has had a
relationship with you and the PHI pertains to that
relationship;
For health care fraud and abuse detection or for activities
related to compliance with the law;
To a family member, other relative, or close personal friend
or other individual involved in your care if we obtain your
verbal agreement to do so or if we give you an opportunity to
object to such a disclosure and you do not raise an objection.
We may also disclose health information to your family,
relatives, or friends if we infer from the circumstances that
you would not object. For example, we may assume you
agree to our disclosure of your personal health information to
your spouse when your spouse has called the ambulance for
you. In situations where you are not capable of objecting
(because you are not present or due to your incapacity or
medical emergency), we may, in our professional judgment,
determine that a disclosure to your family member, relative,
or friend is in your best interest. In that situation, we will
disclose only health information relevant to that person's
involvement in your care. For example, we may inform the
person who accompanied you in the ambulance that you
have certain symptoms and we may give that person an
update on your vital signs and treatment that is being
administered by our ambulance crew;
To a public health authority in certain situations (such as
reporting a birth, death or disease as required by law, as part
of a public health investigation, to report child or adult abuse
or neglect or domestic violence, to report adverse events
such as product defects, or to notify a person about exposure
to a possible communicable disease as required by law;
For health oversight activities including audits or government
investigations, inspections, disciplinary proceedings, and
other administrative or judicial actions undertaken by the
government (or their contractors) by law to oversee the
health care system;
For judicial and administrative proceedings as required by a
court or administrative order, or in some cases in response to
a subpoena or other legal process;
For law enforcement activities in limited situations, such as
when there is a warrant for the request, or when the
information is needed to locate a suspect or stop a crime;
For military, national defense and security and other special
government functions;
To avert a serious threat to the health and safety of a person
or the public at large;
For workers’ compensation purposes, and in compliance with
workers’ compensation laws;
To coroners, medical examiners, and funeral directors for
identifying a deceased person, determining cause of death,
or carrying on their duties as authorized by law;
If you are an organ donor, we may release 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 donation and transplantation;
For research projects, but this will be subject to strict
oversight and approvals and health information will be
released only when there is a minimal risk to your privacy
and adequate safeguards are in place in accordance with the
law.
Uses and Disclosures of Your PHI That Require Your Written Consent
Any other use or disclosure of PHI, other than those listed above, will only
be made with your written authorization(the authorization must specifically
identify the information we seek to use or disclose, as well as when and
how we seek to use or disclose it). Specifically, we must obtain your
written authorization before using or disclosing your: (a) Psychotherapy
notes, other than for the purpose of carrying out our own treatment,
payment or health care operations purposes, (b) PHI for marketing when
we receive payment to make the marketing communication; or (c) PHI
when engaging in a sale of your PHI. 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.
Your Rights Regarding Your PHI
As a patient, you have a number of rights with respect to the protection of
your PHI, including:
Right to access, copy or inspect your PHI. You have the right to inspect
and copy most of the medical information that we collect and maintain
about you. Requests for access to your PHI should be made in writing to
our HIPAA Compliance Officer. 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. If you wish to inspect and copy your medical
