CITY OF BETHLEHEM EMERGENCY MEDICAL SERVICES
This notice describes how medical information about you may be used and disclosed and how you can get access to this information.
Please read carefully. Effective Date April 14, 2003
The City of Bethlehem Emergency Medical Services is required by law to protect the privacy of your protected health information (PHI) and provide you with the Notice of Privacy Practices. This notice outlines our legal duties in respect to your PHI. It also describes our privacy practices and your legal rights, but lets you know among other things, how Bethlehem EMS is permitted to use and disclose PHI about you, how you can access information, how you may request amendment of information, and how you may request restrictions on our disclosure of your PHI.
1. Use and Disclosure Information
- For Treatment: This includes providing our services to you and to assist other health care providers in providing care to you, such as physicians, nurses, and hospitals.
- For Payment: This includes any activities we must undertake in order to get reimbursed for the services we provide to you, such as submitting bills to insurance companies, making medical necessity determinations and collecting outstanding balances.
- To comply with the Law: This is if the use or disclosure is required by law.
- For Healthcare Oversight Activities: This includes audits, governmental 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 or Administrative: This includes proceedings as required by the court or administrative order, or in some case in response to a subpoena or other legal process
- For Law Enforcement Purposes: This includes legal processes required by law, limited information for identification and location purposes, victims of crimes, deaths occurring as a result of a crime.
- To Family Members: This includes individuals involved in your care if we obtain your verbal agreement and in certain other circumstances where we are unable to obtain your agreement and believe the disclosure is in your best interest.
2. Patient Rights
- You have the right to restrict uses or disclosures of your information for treatment, payment or health care operations. You also have the right to ask to restrict disclosers to family members or to others who are involved in your health care or payment for your health care. We may also have policies on dependent access that may authorize certain restrictions. Please note while we will consider your request and will permit requests consistent with its policies, we are not required to agree to any restrictions.
- You have the right to access, copy or inspect your protected health information. In limited circumstances, we may deny you access to your medical information, and you may appeal certain denials.
- You have the right to amend your protected health information. We will generally amend your information unless we believe the information you have asked us to amend is already correct.
- You have the right to request an accounting of your medical information that we have made in the six years prior to the date of request.
- You have a right to an electronic copy and a paper copy of this notice. You may ask for a copy of this notice at anytime.
3. Exercising Your Rights
- Contacting us: If you have questions about this notice, please call the Privacy Officer at 610-865-7111. If you would like to exercise any of your rights, you must describe your request in writing and mail it to the Privacy Officer at the address below.
- Charges: In some instances, we have the right to charge you for the cost associated with providing you with the requested information.
- Filing a Complaint: If you believe your privacy rights have been violated, you may file a written complaint with us at the address below.
City of Bethlehem Emergency Medical Services
540 Stefko Blvd.
Bethlehem, Pa. 18017