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 Peterborough Fire & Rescue Patch. A click on the patch anywhere on this site returns you to the homepage. Peterborough Fire & Rescue 16 Summer Street Peterborough, NH 03458 Emergency Dial 911 603-924-8090 Business 603-924-8091 Fax
Town of Peterborough |
Notice of Privacy StatementIMPORTANT: THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED, DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW THIS NOTICE CAREFULLY. As an essential part of our commitment to you, Peterborough Fire/Rescue 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 Peterborough Fire/Rescue 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. Peterborough Fire/Rescue 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. Peterborough Fire/Rescue respects your privacy and treats all health care information about our patients under strict policies of confidentiality. This Notice is commonly called the HIPPA form. What is HIPAA? HIPAA is the acronym for the Health Insurance Portability and Accountability Act of 1996. Health Insurance Portability and Accountability Act of 1996 (HIPAA, Title II) require the Department of Health and Human Services to establish national standards for electronic health care transactions and national identifiers for providers, health plans, and employers. It also addresses the security and privacy of health data. This Privacy Notice and its requirements are a result of the Act. For detailed information go to www.hipaa.org. IF YOU HAVE ANY QUESTIONS CONTACT PFR Privacy Officer at 603-924-8090
PRIVACY NOTICE This notice of Privacy Practices describes how we may use and disclose your protected health information or “PHI” to carry out your plan of care, get reimbursed for our services, administer our Agency and for other purposes that are permitted or required by law. This Notice also describes your rights with respect to your health information. Uses & Disclosures of PHI Without Your Written Authorization. Peterborough Fire & Rescue is permitted to use PHI without your written authorization, or opportunity to object, in certain situations, and unless prohibited by a more stringent state law, including - For the treatment, payment or health care operations activities or another healthcare provider who treats you; - For health care and legal compliance activities; - 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 objections, and in certain other circumstances where we are unable to obtain your agreement and believe the disclosure is in your best interests; - To a public health authority in certain situations 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 responding to a warrant or conducting an active criminal investigation; - 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 the purposes of 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 PHI 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; - We may also use or disclose PHI in a way that does not personally identify you or reveal who you are, for purposes of quality control, improvement and research. Any other use or disclosure of PHI other than those listed above, or permitted by law, will only be made with your written authorization. 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 PHI, including: The right 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 that you have the right to access. In limited circumstances, we may deny you access to your medial 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 the right to receive confidential communications of your PHI. If you wish to inspect and copy your medical information, you should contact our privacy officer. The right to amend your PHI. You have the right to ask us to amend written medial 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 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 PHI 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 disclosure of your PHI. You have the right to request that we restrict how we use and disclose your medical information that we maintain about you. Peterborough Fire & Rescue is not required to agree to any restrictions you request, but any restrictions agreed to by PFR in writing are binding on PFR. Internet, Electronic Mail, and the right to Obtain Copy of Paper Notice on Request. A copy of this privacy notice will be prominently displayed on our web site: www.firerescue.us . You may request us to forward you a copy of this notice in paper or electronic form. Revisions to this Notice. Peterborough Fire & Rescue 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. You can obtain a copy of the latest version this notice by contacting our Privacy Officer. Your Legal Rights & Complaints. You also have the right to complain to us, or to the Secretary of the United States Department of Health & 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 inquires to our privacy officer.
Privacy Officer Contact Information: Peterborough Fire & Rescue 16 Summer Street Peterborough, NH 03458 (603) 924-8090 Effective Date of the Notice: April 14, 2003 Sections Copyright 2003, Page, Wolfberg & Wirth, LLC
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