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.
As an essential part of our commitment to
you, Juniata College Quick Response Service (QRS
8) maintains the privacy of certain confidential
health care information about you, known as
Protected Health Information or PHI. We are
required by law to protect your health care
information and to provide you with the attached
Notice of Privacy Practices.
The Notice outlines our legal duties and
privacy practices respect to your PHI. It not
only describes our privacy practices and your
legal rights, but lets you know, among other
things, how Juniata College Quick Response
Service (QRS 8) is permitted to use and disclose
PHI about you, how you can access and copy that
information, how you may request amendment of
that information, and how you may request
restrictions on our use and disclosure of your
PHI.
Juniata College Quick Response Service (QRS
8) is also required to abide by the terms of the
version of this Notice currently in effect. In
most situations we may use this information as
described in this 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 ATTACHED DETAILED NOTICE. IF
YOU HAVE ANY QUESTIONS ABOUT IT, PLEASE CONTACT
Connie Peters, OUR PRIVACY OFFICER, AT:
Connie Peters, R.N.
Juniata College
Health & Wellness Center
1700 Moore Street
Huntingdon, PA 16652
814-641-3410
petersc@juniata.edu
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.
Purpose of this Notice: Juniata College Quick
Response Service (QRS 8) is required by law to
maintain the privacy of certain confidential
health care information, known as Protected
Health Information or PHI, and to provide you
with a notice of our legal duties and privacy
practices with respect to your PHI. This Notice
describes your legal rights, advises you of our
privacy practices, and lets you know how Juniata
College Quick Response Service (QRS 8) is
permitted to use and disclose PHI about you.
Juniata College Quick Response Service (QRS
8) is also required to abide by the terms of the
version of this Notice currently in effect. In
most situations we may use this information as
described in this 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.
Uses and Disclosures of PHI: Juniata College
Quick Response Service (QRS 8) 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
reviews, 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, fundraising, and certain marketing
activities.
Fundraising. We may contact you when we are
in the process of raising funds for Juniata
College Quick Response Service (QRS 8), or to
provide you with information about our annual
subscription program.
Reminders for Scheduled Transports and
Information on Other Services. We may also
contact you to provide you with a reminder of
any scheduled appointments for non-emergency
ambulance and medical transportation, or for
other information about alternative services we
provide or other health-related benefits and
services that may be of interest to you.
Use and Disclosure of PHI Without Your
Authorization. Juniata College Quick Response
Service (QRS 8) is permitted to use PHI without
your written authorization, or opportunity to
object in certain situations, including:
- For Juniata College Quick Response
Service (QRS 8) use in treating you or in
obtaining payment for services provided to
you or in other health care operations;
- For the treatment activities of another
health care provider;
- 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);
- To another health care provider (such as
the hospital to which you are transported)
for the health care operations activities of
the entity that receives the information as
long as the entity receiving the information
has or has had a relationship with you and
the PHI pertains to that relationship;
- For health care fraud and abuse
detection or for activities related to
compliance with the law;
- 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
objection. 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 to our 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 care. For example, we
may inform the person who accompanied you in
the ambulance that you have certain symptoms
and we may give that person an update on
your vital signs and treatment that is being
administered by our ambulance crew;
- 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;
- For health oversight activities
including audits or government
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 and administrative
proceedings as required by a court or
administrative order, or in some cases in
response to a subpoena or other legal
process;
- 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;
- For military, national defense and
security and other special government
functions;
- To avert a serious threat to the health
and safety of a person or the public at
large;
- For workers’ compensation purposes, and
in compliance with workers’ compensation
laws;
- 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;
- 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;
- 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;
- 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 or 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 in reliance on
that authorization.
Patient 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 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 reasonable fee for you to copy any
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 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. If you wish to inspect and copy
your medical information, you should contact the
privacy officer listed at the end of this
Notice.
The right to amend your 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 your request to amend your medical
information only in certain circumstances, like
when we believe the information you have asked
us to amend is correct. If you wish to request
that we amend the medical information that we
have about you, you should contact 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,
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 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. But 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. Juniata College Quick Response
Service (QRS 8) is not required to agree to any
restrictions you request, but any restrictions
agreed to by Juniata College Quick Response
Service (QRS 8) are binding on Juniata College
Quick Response Service (QRS 8).
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.
Revisions to the Notice: Juniata College
Quick Response Service (QRS 8) 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:
Connie Peters, R.N.
Juniata College
Health & Wellness Center
1700 Moore Street
Huntingdon, PA 16652
814-641-3410
petersc@juniata.edu
Effective Date of the Notice: April 15, 2003.
Welcome!
