OUR PLEDGE TO YOU AND OUR RESPONSIBILITY:
STAT AIR INTERNATIONAL
501 W Broadway STE. A-116, San Diego, California 92101 USA +1 619-754-6550
We understand that information about you and your health is personnel and confidential. We are committed to protect the privacy of this information. We create a medical record of the care you receive because it is our legal obligation, but more importantly because we want to provide you with quality care. This notice applies to all of the records of your care created by our air Ambulance team, including information from the referring and receiving facilities, and/or your physicians to provide a quality of continuum care. Please understand that your personal doctor may have different policies or notices regarding the use and disclosure of the medical information created in his or her office. This notice will tell you about the specific way Stat Air International and our facilities may use and disclose your medical information. This notice also describes your rights and the duties we have regarding the use and disclosure of your medical information. Federal and California law makes us responsible for safeguarding your personal health information.
HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU: The following is a list of ways in which your personal medical information may be used and disclosed as allowed under HIPAA provisions. Please know we are committed to protecting your personal medical information from any use for which it was not intended.
Disclosure to Health Care Related Services without your authorization: Treatment: to provide or coordinate your medical care and services. Payment: for billing arrangements and authorization from you insurance/collection agencies. Health care operations: uses and discloses of health information are necessary to operate our air ambulance and to ensure all of our patients receive quality of care. For example, quality assurance reports, customer services, and financial/business planning and development, ect. Disclosure for other Service without your authorization:
- Organ/Tissue donation
- Research that does not involve your treatment
- Public Health reasons
- Abuse/Neglect Reporting
- Workmans Compensation Disclosure for Legal Services without authorization:
- Lawsuits/disputes under a court order
- National Security and Intelligence Activities
- Military/Veterans as required by military command authorities
- Inmates as required by the correctional institution or the law enforcement official
- Legal requirements: we will disclose health information about you without your permission when required to do so by federal or California law.
Disclosure to Friends, family or others only with your Verbal Agreement:
With your consent we may disclose your information to those involved in your medical care. In addition, we may disclose health information about you to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status and location.
In any other situation not covered by this notice, we will ask for your written authorization before using or disclosing your medical information. If you choose to authorize use or disclose you can later revoke that authorization by notifying us in writing of your decision.
YOUR RIGHTS REGARDING HEALTH INFORMATION ABOUT YOU
- Obtaining a copy of our Privacy Practices.
- Request a restriction on certain uses and disclosures of your information. This must be in writing. If we agree to your request, we will comply unless the information is needed to provide you with emergency treatment.
- Inspect and request a copy of your health record. A reasonable fee for copies may apply. We may deny you request under limited circumstances. If we deny your request to review or obtain a copy you may submit a written request for a review of that decision by another healthcare official on our team.
- Request an amendment to your health record if you feel the information is incorrect or incomplete. Your request must be made in writing and it must include a reason that supports your request. We may deny your request if the information was not created by our team, it is not part of the information kept by our entity, if it is not part of the information in which you are permitted to inspect or copy or if the information is accurate and complete as stated. Please note: If we accept your request for amendment, we are not required to delete any information from your health record.
- Obtain an accounting of disclosures to others of your health information. The accounting will provide information about disclosures made for purpose other that treatment, payment, health care operation, disclosures excluded by law or those you have authorized.
- Request confidential communications. You have the right to write a request that we communicate with you about health issues in a certain way or at a certain location such a place of work or by mail. We will accommodate all requests that are reasonable to our capabilities.
- Revoke your authorization. You have the right to revoke your authorization of the use of disclosure of your health information except to the extent that action has already been taken.
Effective Date of the Notice: April 14, 2003