Notice of Privacy Practices
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED IN CONNECTION WITH YOUR PERSONAL EMERGENCY RESPONSE SERVICES. PLEASE REVIEW THIS NOTICE CAREFULLY.
ResponseLink has voluntarily adopted the stringent federal privacy standards to maintain the privacy of your Personal Health Information (PHI). This Notice of Privacy Practices describes how we may use and disclose your PHI in the course of providing you with personal emergency response services, and describes your rights with respect to your PHI.
If you have any questions, please contact at 1-888-229-8488.
OUR PLEDGE REGARDING INFORMATION:
We are committed to protecting information about you and your health. We create a record of the care and services you receive from us. We need this record to provide you with quality care and to contact emergency health services if needed. This notice applies to all of our records.
We pledge to:
- Maintain the privacy of your information
- Give you this notice of our legal duties and privacy practices related to your information
- Follow the terms of all of our written privacy policies that are in effect at the time.
HOW WE MAY USE AND DISCLOSE INFORMATION ABOUT YOU:
Treatment. We will use and disclose PHI to treat or provide services to you. For example, a physician may suggest that you would benefit from our services and ask us to explain them to you, or may wish to know the nature of any emergency calls made to or from you. We may record information obtained from your physician or other healthcare providers and from our monitoring center, to ensure adequate coordination of your care. We disclose PHI only to other persons who are actively involved in providing for your health and welfare.
Payment. We will use and disclose PHI so that we can bill and be paid for services you receive from us. For example, we may need to give information about your treatment and diagnosis to an insurance company or state agency so they will pay for your treatment if our services are covered by an insurer or a state agency.
Health Care Operations. We may use and disclose PHI as needed to carry out our organizational needs. For example, we may use or review PHI with out Central Monitoring Station to monitor the performance of staff to improve our quality of care.
Business Associates. Some services such as the delivery of supplies may be provided by us through contracts with business associates. When services are contracted to an associated entity, we require the business associate to follow the same policies that we have implemented to safeguard your PHI.
Those Involved in Your Care. We may release relevant PHI to a friend, family member, or to someone you designate as an emergency contact who is involved in your care or payment related to your care. We may also disclose PHI to those assisting in disaster relief efforts so that your family can be notified about your condition, status and location. If you advise us of any family member that you do not wish to have access to your PHI, we will honor that direction.
Other. We may use or disclose PHI for the following purposes:
- To avert a threat to health or safety
- To public health agencies
- Judicial and administrative proceedings
- To government agencies/ functions
- As required by law
- Worker’s compensation
- Health oversight activities
- If we believe you are a victim of abuse
- Custodial law enforcement
- To avert a threat to health or safety
- To public health agencies
- Judicial and administrative proceedings*To government agencies/ functions
* If you are an organ donor
You have the following rights regarding information we maintain about you:
Right to Inspect and Copy. You have the right to inspect and obtain a copy of the PHI contained in your medical record. You must submit your request in writing to: ResponseLink, ATTN: Privacy Officer, 325 N. 48th St, Tempe, AZ In some cases, we may deny your request. There may be a fee for the costs of copying, mailing or supplies involved in granting your request.
Right to Amend. If you believe that your PHI is incorrect or incomplete, you may ask us to amend your PHI. You must submit your request along with the reason for amendment in writing to: ResponseLink, ATTN: Privacy Officer, 325 S. 48th St, Suite 108, Tempe, AZ. 85281. In certain cases, we may deny your request, but you have the right to understand why we are denying the request and to file a statement of disagreement.
Right to an Accounting of Disclosures. You may receive an accounting of disclosures of your PHI made for purposes other than treatment, payment or health care operations as described in this Notice unless those disclosures were made to you or as a result of your specific written permission, or were made to government agencies or for governmental functions. You may submit your request in writing to our Privacy Officer. The request must include the time period (not longer than six years) for the disclosures you wish to be listed. The first list you request within a 12 month period will be free, but we may charge you for the costs of providing additional accountings within a 12 month period. We will notify you of the costs involved in advance and you will have the opportunity to withdraw your request.
Right to Request Restrictions. You have the right to request restrictions on the PHI we use or disclose about you in connection with treatment, payment, health care operations. In some cases, we may not agree to your request. You must submit your request for restrictions in writing.
Right to Request Confidential Communications. You have the right to request that we communicate with you in a certain way or at a certain location. You must submit your request for confidential communications in writing. We will honor reasonable requests.
Right to Change Terms/ Copy of This Notice. We reserve the right to change the terms of this notice, and apply any changes to all PHI that we maintain. We will post a current copy of this notice in our facilities and on our website at www.ResponseLink.com. You also have the right to a copy of this notice at any time. To obtain a paper copy of this notice, please contact our Privacy Officer. A copy may also be requested in writing to: ResponseLink, ATTN: Privacy Officer, 325 S. 48th St, Suite 108, Tempe, AZ. 85281.
If you believe your privacy rights have been violated, you may file a complaint with us. To file a complaint with us, contact our Privacy Officer at 480-784-4600, ext. 203. You will not be penalized for filing a complaint.
OTHER USES AND DISCLOSURES OF INFORMATION
Other uses and disclosures of PHI not covered by this notice will be made only with your authorization. You may also revoke an authorization you make at any time by sending a request in writing. After you revoke your authorization, we will no longer use or disclose your identifiable health information for the reasons described in the authorization, except to the extent we have already taken action in reliance upon your authorization.
Effective Date: August 1, 2006.