The rights to access, copy or inspect your PHI: This means you may 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 reasonable fee for you to copy any 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. You also have to right to receive confidential communication of your PHI. If you wish to inspect and copy your medical information, you should contact our privacy officer.

The right to amend you PHI: You have the right to ask us to amend written medical information that we may have about you. 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 you request to amend your medical information only in certain circumstances, like when we believe the record you have asked us to amend is complete and accurate. If you wish to request that we amend the medical information that we have about you, you should contact our privacy officer.

The right to request an accounting: You may request an accounting from us of certain disclosures of your medical information that we have made in the 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, like 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, contact our privacy officer.

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. Central Air Ambulance is not required to agree to any restrictions you request, but any restrictions agreed to Central Air Ambulance in writing are binding on Central Air Ambulance.

Internet, Electronic mail, and the Right to Obtain Copy if Paper Notice on Request. If we maintain a web site, we will prominently post a copy of this Notice on your web site. If you allow us, we may forward you this Notice by electronic mail instead of on paper and you may always request a paper copy of the Notice.

Revisions to the Notice: Central Air Ambulance 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 to our web site, if we maintain one. You can get a copy of the latest version of this Notice by contacting our privacy officer.

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 filling a complaint with us or to the government. Should you have any Questions, comments or complaints you may direct all inquiries to our privacy officer.

                                       

Privacy Officer Contact Information:

                                                Pam Morris
                                                Central Air Ambulance
                                                205 Hembree Park Drive
                                                Suite 100
                                                Roswell, GA 30076

Effective Date of the notice: April 14, 2007

 

For questions about this notice or your account, please call our Customer Service Department at (866) 910-6744