FIRE SERVICE & AMBULANCE SERVICE BILLING QUESTIONS : CONTACT
Beckley, West Virginia 25801
Phone: (800) 635-7577 (Nationwide) (304) 253-1059 (Fax) 1. For the following reasons documented in our agreements: a. To obtain payment for treatment. b. For health care operations. 2. We may use and disclose PHI which are not documented in our agreements: . When a disclosure is required by federal, state or local law, judicial or administrative proceedings, or law enforcement. a. For public health activities. b. For health oversight activities. c. For research purposes. d. To avoid harm. e. For specific government functions. 3. All other uses and disclosures require prior written authorization. 1. The right to request limits on uses and disclosures of PHI. 2. The right to choose how we send PHI to you. 3. The right to see and get copies of your PHI. 4. The right to get a list of the disclosures we have made. 5. The right to get this notice by e-mail.
Our Privacy Policies This notice describes how trading partners, business associates and other covered entities' patient health information may be used and disclosed and how they can get access to this information. Please review it carefully.
II. PMC has a legal duty to safeguard Protected Health Information (PHI).PMC is legally required to protect the privacy of health information. This information is called "protected health information," or "PHI" for short, and it includes information that can be used to identify a patient that we received about a past, present, or future health condition, the provision of health care to the patient, or the payment for health care. We provide this notice to trading partners, business associates and other covered entities to explain how, when, and why we use and disclose PHI. With some exceptions, we may not use or disclose any more PHI than is necessary to accomplish the purpose of that use or disclosure. We are legally required to follow the privacy practices that are described in this notice.However, PMC reserves the right to change the terms of this notice and our privacy policies at any time. Any changes will apply to the PHI we already have. Any significant change to our policies will be reflected in this document, and notice of such change will be clearly posted on our web site at www.prioritymedicalclaims.com. You can also request a copy of this notice from the contact person listed in Section VI below at any time.
III. How we may use and disclose Protected Health Information?PMC uses and discloses health information for many different reasons. These disclosures are further detailed in the Business Associate Contract we have executed with you. Below, we describe the different categories of our uses and disclosures and give some examples of each category.
PMC uses and discloses PHI on behalf of health care providers in order to forward insurance claims electronically and on paper for payment by insurance carriers, and to electronically forward patient billing information for collections.
PMC uses and discloses PHI on behalf of insurance payers by forwarding responses regarding the status of insurance claims to health care providers. PHI may also be disclosed to health care providers, insurance companies, and other covered entities as part of the Provider Enrollment, Payer Connections and Customer Service operations of the organization. We may also provide PHI to our attorneys, consultants and others in order to ascertain our compliance with the laws that affect us.
For example, PMC will make disclosures when a law requires that we report information to government agencies and law enforcement personnel, or when ordered in a judicial or administrative proceeding.
In certain circumstances, we may report information about births, deaths, and various diseases, to government officials in charge of collecting that information.
For example, we will provide information when required by a governmental agency conducting an investigation or inspection of a health care provider or organization.
For example, we may provide PHI in order to conduct medical research.
In order to avoid a serious threat to the health or safety of a person or the public, we may provide PHI to law enforcement personnel or persons able to prevent or lessen such harm.
PMC may disclose PHI of military personnel and veterans in certain situations. And we may disclose PHI for national security purposes.
In any other situation not described in sections III-A or B above, PMC will ask for written authorization before using or disclosing any trading partners, business associates and other covered entities' PHI. This authorization can later be revoked in writing to stop any future uses and disclosures, to the extent that PMC has not taken any action relying on the authorization.
IV. Rights regarding PHIAs a trading partner, business associate or other covered entity you have the following rights with respect to PHI:
You have the right to ask that PMC limit how we use and disclose your PHI. We will consider your request but are not legally required to accept it. If we accept your request, we will put any limits in writing and abide by them except in emergency situations. You may not limit the uses and disclosures that we are legally required or allowed to make.
You have the right to ask that we send information to an alternate address (physical or electronic) or by alternate means (regular mail or electronic). We must agree to your request so long as we can easily provide it in the format you requested.
In most cases, you have the right to look at or get copies of your PHI that we have. If PMC does not have your PHI but know who does, we will tell you that. If a request is made for PHI other than as discussed above, you must make the request in writing. PMC will respond to you within 30 days of receipt of your written request. In certain situations, we may deny your request. If we do, we will tell you, in writing, our reasons for the denial and explain your right to have the denial reviewed.
You have the right to get a list of instances in which we have disclosed your PHI. The list will not include uses or disclosures that you have already consented to, such as those made for payment or health care operations. The list also will not include uses and disclosures made for national security purposes, to corrections or law enforcement personnel, or before April 3, 2002.
You have the right to get a copy of this notice by e-mail. Even if you have agreed to receive notice via e-mail, you also have the right to request a paper copy of this notice.
V. How to complain about our privacy practices:If you think that PMC may have violated your privacy rights, or you disagree with a decision we made about access to your PHI, you may file a complaint with the person listed in Section VI below. You also may send a written complaint to: Secretary of the Department of Health and Human ServicesOffice for Civil Rights
U.S. Department of Health and Human Services
601 East 12th Street, Room 248
Kansas City, MO 64106 or E-mail: OCRComplaint@hhs.govor fax: (816) 426-3686.We will take no retaliatory action against you if you file a complaint about our privacy practices.
VI. Person to contact for information about this notice or to complain about our privacy practices.If you have any questions about this notice or any complaints about our privacy practices, or would like to know how to file a complaint with the Secretary of the Department of Health and Human Services, please contact: Keith Waycaster, Compliance Officer
Priority Medical Claims, Inc.
PO Box 999
Oceana, WV 24870or E-mail: firstname.lastname@example.org call: 1-800-635-7577 Ext. 105
VII. Effective date of this notice.This notice went into effect on January 1st, 2007.
VIII. Supercedes all others written and/or oral.
(304) 253-1059 (Fax)
1. For the following reasons documented in our agreements:
a. To obtain payment for treatment.
b. For health care operations.
2. We may use and disclose PHI which are not documented in our agreements:
. When a disclosure is required by federal, state or local law, judicial or administrative proceedings, or law enforcement.
a. For public health activities.
b. For health oversight activities.
c. For research purposes.
d. To avoid harm.
e. For specific government functions.
3. All other uses and disclosures require prior written authorization.
1. The right to request limits on uses and disclosures of PHI.
2. The right to choose how we send PHI to you.
3. The right to see and get copies of your PHI.
4. The right to get a list of the disclosures we have made.
5. The right to get this notice by e-mail.