EMP Medical Services, Inc. We make it our business to care. Home Health Care Management
Notice of Privacy Practices
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 Privacy Officer:
Raisa Gomez
2850 Douglas Road, 3rd Floor
Miami, Fl 33134
Tel: (305) 446-4521
Fax: (305) 441-8188
What does a notice of privacy tell you
The Notice of Privacy Practices describes how we may use and disclose your protected health information to carry out treatment, payment or health care operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. "Protected Health Information" (PHI) is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services. We are required to abide by the terms of this Notice of Privacy Practices. We may change the terms of our notice, at any time. The new notice will be effective for all protected health information that we maintain at that time. Upon your request, we will provide you with any revised Notice of Privacy Practices by, calling the office and requesting that a revised copy be sent to you in the mail.
OUR SERVICES AND PLEDGE REGARDING YOUR HEALTH INFORMATION WHICH IS PRIVATE
EMP Medical Services, Inc., is able to provide superior comprehensive home services by coordinating durable medical equipment, nursing, respiratory, nursing, social services, pharmacy (infusion and injectables) and rehabilitation services through its extensive network of providers. Our complete, coordinated care combines experienced professionals and quality products. We understand that information we collect about you and your health is personal. We are committed to protecting your health information and following all laws regarding the use of your health information.
HOW WE MAY USE OR DISCLOSE YOUR HEALTH INFORMATION
Uses and Disclosures of Protected Health Information Your protected health information is usually sent to us by your physician, physician's office staff or others outside of our office that are involved in your care and treatment, for the purpose of providing services to you. In turn we utilize this information to coordinate the delivery of care, receive payment for the services provided and to support the operations of EMP Medical Services, Inc. The following are examples of the types of uses and disclosures of your protected health care information that EMP Medical Services, Inc. is permitted to make. These examples are not meant to be exhaustive, but to describe the types of uses and disclosures that may be made by our office.
Treatment: We will use and disclose your protected health information to provide, coordinate, or manage services in the home such as medical equipment, nursing, pharmacy, pharmacy supplies. This includes the coordination or management of your health care with a third party. We would disclose your protected health information, as necessary, to home care agencies who will be providing services to you. We may also disclose protected health information to physicians who may be treating you. For example, your protected health information may be provided to a physician to whom you have been referred to ensure that the physician has the necessary information.
Payment: Your protected health information will be used, as needed, to obtain payment for services provided to you. This may include certain activities that your health insurance plan may undertake before it approves or pays for the services provided such as; making a determination of eligibility or coverage for insurance benefits, reviewing services for medical necessity, and undertaking utilization review activities. For example, obtaining approval for certain medications or equipment may require that your relevant protected health information be disclosed to the health plan to obtain approval for services. Healthcare Operations: We may use or disclose, as-needed, your protected health information in order to support the business activities of the organization. These activities include, but are not limited to, accreditation activities, quality assessment activities, employee review activities, training, licensing, marketing and fundraising activities, and conducting or arranging for other business activities. We may use or disclose your protected health information, as necessary, to contact you to schedule services and determine quality of care. We will share your protected health information with third party "business associates" that perform various activities. Whenever an arrangement between our office and a business associate involves the use or disclosure of your protected health information, we will have a written contract that contains terms that will protect the privacy of your protected health information. We may use or disclose your protected health information, as necessary, to provide you with information about treatment alternatives or other health-related benefits and services that may be of interest to you. We may also use and disclose your protected health information for other marketing activities. For example, we may send you information about products or services that we believe may be beneficial to you. You may contact our Privacy Officer to request that these materials not be sent to you. We may use or disclose your demographic information and the dates that you received services, in order to contact you for fundraising activities supported by our office. If you do not want to receive these materials, please contact our Privacy Officer and request that these fundraising materials not be sent to you. In addition, our office may post thank you cards and other holiday cards received from patients in lobby bulletin boards or other general areas.
WHAT IF MY INFORMATION NEEDS TO GO SOMEWHERE ELSE
Other uses and disclosures of your protected health information will be made only with your written Authorization, unless otherwise permitted or required by law as described below. You may revoke this Authorization, at any time, in writing, except to the extent that we have taken an action in reliance on the use or disclosure indicated in the Authorization.
COULD MY HEALTH INFORMATION BE RELEASED WITHOUT MY PERMISSION
We may use and disclose your protected health information in the following instances. To others involved in your health care: We may release medical information about you to a friend or family member who is involved in your medical care. We may also tell your family or friends your condition as directed by you. In addition, we may disclose medical information about you to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status or location.
Emergencies: We may use or disclose your protected health information in an emergency treatment situation. Other Permitted and Required Uses and Disclosures That May Be Made Without Your Authorization or Opportunity to Object: We may use or disclose your protected health information in the following situations without your Authorization. These situations include: Required By Law: We may use or disclose your protected health information to the extent that the use or disclosure is required by law. The use or disclosure will be made in compliance with the law and will be limited to the relevant requirements of the law. You will be notified, as required by law, of any such uses or disclosures. Public Health: We may disclose your protected health information for public health activities and to a public health authority that is permitted by law to collect or receive the information.
These activities generally include the following: prevent or control disease, injury or disability, to notify people of recalls of products they may be using, notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition, to report abuse or neglect or domestic violence. Health Oversight Activities: We may disclose medical information to a health oversight agency for activities authorized by law. These include audits, investigations and licensures. These activities are necessary for government to monitor the health care system, government programs, and compliance with civil rights laws.
Law Enforcement: We may also disclose protected health information, so long as applicable legal requirements are met, for law enforcement purposes. These law enforcement purposes include (1) legal processes and otherwise required by law, (2) limited information requests for identification and location purposes, (3) pertaining to victims of a crime, (4) suspicion that death has occurred as a result of criminal conduct, (5) in the event that a crime occurs on the premises, and (6) medical emergency and it is likely that a crime has occurred.
Legal Proceedings: We may disclose protected health information in the course of any judicial or administrative proceeding, in response to an order of a court or administrative tribunal (to the extent such disclosure is expressly authorized), in certain conditions in response to a subpoena, discovery request or other lawful process. Coroners, Funeral Directors, and Organ
Donation: We may disclose protected health information to a coroner or medical examiner for identification purposes, determining cause of death or for the coroner or medical examiner to perform other duties authorized by law. We may also disclose protected health information to a funeral director, as authorized by law, in order to permit the funeral director to carry out their duties. We may disclose such information in reasonable anticipation of death. Protected health information may be used and disclosed for cadaver organ, eye or tissue donation purposes.
Research: We may disclose your protected health information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your protected health information.
Criminal Activity: Consistent with applicable federal and state laws, we may disclose your protected health information, if we believe that the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public. We may also disclose protected health information if it is necessary for law enforcement authorities to identify or apprehend an individual.
Military Activity and National Security: When the appropriate conditions apply, we may use or disclose protected health information of individuals who are Armed Forces personnel (1) for activities deemed necessary by appropriate military command authorities; (2) for the purpose of a determination by the Department of Veterans Affairs of your eligibility for benefits, or (3) to foreign military authority if you are a member of that foreign military services. We may also disclose your protected health information to authorized federal officials for conducting national security and intelligence activities, including for the provision of protective services to the President or others legally authorized.
Workers' Compensation: Your protected health information may be disclosed by us as authorized to comply with workers' compensation laws and other similar legally-established programs.
Inmates: We may use or disclose your protected health information if you are an inmate of a correctional facility and your physician created or received your protected health information in the course of providing care to you.
Required Uses and Disclosures: Under the law, we must make disclosures to you and when required by the Secretary of the Department of Health and Human Services to investigate or determine our compliance.
YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION
You have the right to inspect and copy your protected health information. Usually this includes medical and billing records. To inspect and copy medical information that may be used to make decisions about you, you must submit your request in writing to the Privacy Officer. If you request a copy of the information, we may charge a fee for the costs of copying, mailing or other supplies associated with your request. Under Federal law, however, you may not inspect or copy information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding, and protected health information that is subject to law that prohibits access to protected health information. Depending on the circumstances, a decision to deny access may be reviewed. Please contact our Privacy Officer if you have questions about access to your medical record. You have the right to request a restriction of your protected health information. This means you may ask us not to use or disclose any part of your protected health information for the purposes of treatment, payment or healthcare operations. You may also request that any part of your protected health information not be disclosed to family members or friends who may be involved in your care or for notification purposes as described in this Notice of Privacy Practices. Your request must state the specific restriction requested and to whom you want the restriction to apply.
EMP Medical Services, Inc. is not required to agree to your restriction request, especially if it believes it is not in your best interest. If we do agree to the requested restriction, we may not use or disclose your protected health information in violation of that restriction unless it is needed to provide emergency treatment.
To request restrictions, please make request in writing to our Privacy Officer. Please indicate what information you want to limit, whether you want to limit use or disclosure or both and to whom you want the limits to apply, for examples, disclosures to your spouse.
You have the right to request to receive confidential communications from us by alternative means or at an alternative location. We will accommodate reasonable requests. We may also condition this accommodation by asking you for information as to how payment will be handled or specification of an alternative address or other method of contact. Please make this request in writing to our Privacy Officer indicating how or where you wish to be contacted. You may have the right to have your physician amend your protected health information. This means you may request an amendment of protected health information if you feel that medical information we have about you is incorrect or incomplete.
You have the right to request an amendment for as long as we maintain the information. An amendment request must be made in writing and submitted to the privacy officer. In addition, you must provide a reason that supports your request. We may deny your request if it is not in writing or does not include a reason to support the request, the information was not created by us, is not part of information kept by us, is not part of information which you would be permitted to inspect and copy or information is accurate and complete.
You have the right to file a complaint in writing and we will prepare a written response to your complaint. Please contact our Privacy Officer if you have questions about amending your medical record. You have the right to receive an accounting of certain disclosures we have made, if any, of your protected health information. This right applies to disclosures for purposes other than treatment, payment or healthcare operations as described in this Notice of Privacy Practices. You have the right to receive specific information regarding these disclosures that occurred after April 14, 2003. You may request a shorter timeframe. The right to receive this information is subject to certain exceptions, restrictions and limitations. You have the right to obtain a paper copy of this notice from us, upon request, even if you have agreed to accept this notice electronically.
QUESTIONS OR COMPLAINTS
You may complain to us or to the Secretary of Health and Human Services if you believe your privacy rights have been violated by us. You may file a complaint with us by notifying our Privacy Officer. We will not retaliate against you for filing a complaint.
You may contact our Privacy Officer, Raisa Gomez at (305) 446-4521 for further information about the complaint process. This notice was published and becomes effective on April 14, 2003
NOTICE OF PRIVACY PRACTICES ACKNOWLEDEGMENT
I understand that under the Health Insurance Portability Act of 1996 (HIPAA) that I have certain rights to privacy regarding my Protected Health Information (PHI). I understand that the information can and will be used to:
I have received, read and understand EMP Medical Services, Inc. Notice of Privacy Practices containing a more complete description of the uses and disclosures of my health information. I understand that this organization has the right to change its Notice of Privacy Practices from time to time and that I may contact this organization at any time to obtain a current copy of the Notice of Privacy Practices.
I understand that I may request in writing that you restrict how my private information is used or disclosed to carry out treatment, payment or health care operations. I also understand you are not required to agree to my requested restriction, but if you do agree than you are bound to abide by such restrictions.
Conduct, plan and direct my treatment and follow-up among the multiple health care providers who may be involved in that treatment directly and indirectly.
Obtain payment from third party payers.
Conduct normal healthcare operation such a quality assessments and physician certifications.
