Patient Privacy Statement
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.
Speech Solutions, Inc. is required by law to
protect certain aspects of your health care information known as Protected
Health Information or PHI and to provide you with this Notice of Privacy
Practices.
This Notice describes our privacy practices, your
legal rights, and lets you know, how Speech Solutions, Inc. is permitted to
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Use
and disclose PHI about you
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How
you can access and copy that information
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How
you may request amendment of that information
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How
you may request restrictions on our use and disclosure of your PHI.
In most situations we may use this information
described in the Notice without your permission, but there are some situations
where we may use it only after we obtain your written authorization, if we are
required by law to do so.
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 are committed to following at all times.
PLEASE READ THE FOLLOWING DETAILED NOTICE. IF
YOU HAVE ANY QUESTIONS ABOUT IT, PLEASE CONTACT THE: HIPAA Privacy Officer
Liaison at 910-671-9629 and someone will contact you.
Purpose of this Notice: This Notice
describes your legal rights, advises you of our privacy practices, and lets you
know how Speech Solutions, Inc. is permitted to use and disclose Protected
Health Information (PHI) about you.
Uses and Disclosures of PHI: Speech
Solutions, Inc. 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:
For 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
For 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 review, utilization review, and collection of outstanding
accounts.
For Health Care 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.
Use and Disclosure of PHI Without Your
Authorization: Speech Solutions, Inc. is permitted to use PHI without your
written authorization, or opportunity to object in certain situations,
including:
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For
Speech Solutions, Inc. use in treating you or in obtaining payment for
services provided to you or in other health care operations;
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For
the treatment activities of another health care provider;
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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);
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To
another health care provider (such as the hospital to which you are
transported or First Responder Agencies) for the health care operations
activities of the covered entity that receives the information as long as
the covered entity receiving the information has or has had a relationship
with you and the PHI pertains to that relationship;
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For
health care fraud and abuse detection or for activities related to
compliance with the law;
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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 objections. 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 tour 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 case. For example, we may
inform the person who accompanied you in the ambulance that you have certain
symptoms and we may give that
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person an update on your vital signs and treatment that is being
administered by our ambulance crew;
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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);
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For
health oversight activities including audits or government investigations,
inspections, disciplinary proceedings, and other administrative or judicial
actions undertaken by the government (or other contractors) by law to
oversee the health care system;
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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;
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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;
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For
military, national defense and security and other special government
functions;
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To
avert a serious threat to the health and safety of a person or the public at
large;
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For
workers’ compensation purposes, and in compliance with workers’ compensation
laws;
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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;
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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;
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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;
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We
may use or disclose health information about you in a way that does not
personally identify you or reveal who you are.
Any other use of 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). You may
revoke your authorization at any time, in writing, except to the extent that we
have already used or disclosed medical information based upon that
authorization.
Patients Rights: As a patient, you
have a number of rights with respect to the protection of your PHI, including:
The right to access, copy or inspect your PHI.
This means that you may come to our offices and
inspect and copy most of the medical information about you that we maintain. We
will normally provide you with access to this information within 30 days of your
request. We may also charge you a fee for you to copy and medical information
that you have the right to access. In limited circumstances, we may deny you
access to your medical information, and you may appeal certain types of
denials. We have forms available for you to request access to your PHI. 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 information, you
should contact the privacy officer liaison listed at the end of this Notice.
The right to amend your PHI. The right
to request amending your PHI.
You have the right to ask us to amend written
medical information that we may have about you. If errors are found, we will
generally amend your information within 60 days of your request and will notify
you when we have amended the information. We are permitted by law to deny your
request to amend your medical information, but only in certain circumstances.
For example, if we believe the information is correct and no errors exist, your
request will be denied. If you wish to request that we amend the medical
information that we have about you, you should contact in writing the privacy
officer listed at the end of this Notice.
The right to request an accounting of our use
and disclosure of your PHI.
You may request an accounting from us of certain
disclosures of your medical information that we have made in the last six years
prior to the date of your request. We are not required to give you an
accounting of information we have used or disclosed for purposes of treatment,
payment or health care operations, or when we share your health information with
our business associates, such as our billing company or a medical facility
from/to which we have transported you. We are also not required to give
you an accounting of our uses of protected health information for which you have
already given us written authorization. If you wish to request an accounting of
the medical information about you that we have used or disclosed that is not
exempted from the accounting requirement, you should contact the privacy officer
listed at the end of this Notice.
The right to request that we restrict the uses
and disclosures of your PHI.
You have the right to request that we restrict
how we use and disclose your medical information that we have about you for
treatment, payment or health care operations, or to restrict the information
that is provided to family, friends and other individuals involved in your
health care. However, if you request a restriction and the information you
asked us to restrict is needed to provide you with emergency treatment, then we
may use the PHI or disclose the PHI to a health care provider to provide you
with emergency treatment. Speech Solutions, Inc. is not required to agree to
any restrictions you request, but any restrictions agreed to by Speech
Solutions, Inc. are binding on Speech Solutions, Inc.
Internet, Electronic Mail, and the Right to
Obtain Copy of Paper Notice on Request.
If we maintain a web site, we will prominently
post a copy of this Notice on our web site and make the Notice available
electronically through the web site. If you allow us, we will forward you this
Notice by electronic mail instead of on paper and you may always request a paper
copy of the Notice.
Revise to the Notice: Speech Solutions,
Inc. reserves the right to change the terms of this Notice at any time, and the
changes will be effective immediately and will apply to all protected health
information that we maintain. Any material changes to the Notice will be
promptly posted in our facilities and posted to our web site, if we maintain
one. You can get a copy of the latest version of this Notice by contacting the
Privacy Officer identified below.
Your Legal Rights and Complaints: You
also have the right to complain to us, or to the Secretary of the United States
Department of Health and Human Services if you believe your privacy rights have
been violated. You will not be retaliated against in any way for filing a
complaint with us or to the government. Should you have any questions, comments
or complaints you may direct all inquiries to the privacy officer listed at the
end of this Notice. Individuals will not be retaliated against for filing a
complaint.
If you have any questions or if you wish to file
a complaint or exercise any rights listed in this Notice, please contact:
Speech Solutions, Inc. PO Box 1288 Lumberton, NC
28359 910-671-9629
Effective Date of the Notice: April 14, 2003 |
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