Policy Statement
Enhanced Management Services® conducts
ambulance billing services for ambulance companies and
medical transportation companies in compliance with all
laws and regulations.
Enhanced
Management Services, Inc.® is committed to conducting
its business practices with integrity, honesty, and
compassion, and in compliance with the laws and regulations
that govern its operations. In order to achieve this
commitment, we have periodically adopted policies and
procedures that are intended to guide our actions and
protect against unlawful activity. Our Code of Conduct
has been specifically designed to provide the necessary
guidance that will allow each of us to perform our
jobs with the highest level of integrity, and thereby
avoid even the appearance of unlawful behavior.
However, we must all make personal
commitments to adhere to these guiding principles
and to comply with our policies, procedures and
regulatory requirements. If you have questions
or concerns about what is appropriate conduct,
or if you become aware of any situation that may
jeopardize the ethical integrity of our organization,
I must ask that you please refer to the Code of Conduct,
or promptly contact your supervisor, another member
of management, or our Compliance Officer, Joel B. Gum,
at (570) 271-1120. However, if you feel that your concern
has not been addressed to your satisfaction, or if
you would prefer to remain anonymous, you can call
our toll-free Compliance Line at 1-866-839-1063.
Enhanced Management Services,
Inc.® (EMS) depends on all of us to carry out its values
and achieve its mission of responding to the reimbursement
needs of our clients. We must all commit ourselves
to conducting business ethically and in accordance
with applicable laws, rules and regulations.
Notice
of Privacy Practices
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.
Enhanced Management Services, Inc.® ("Enhanced")
is a recognized leader in the ambulance billing industry,
providing superior billing and staffing services for
ambulance and medical transportation companies. As
an essential part of our commitment to our clients,
we maintain the privacy of our clients' patients' confidential
health care information concerning their patients,
known as Protected Health Information or "PHI".
We are required by law to protect our clients' patients'
health care information. The Notice outlines our legal
duties and privacy practices respect to our clients'
patients' PHI. It not only describes our privacy practices
and the legal rights of our clients and their patients,
but it lets you know, among other things, how Enhanced
is permitted to use and disclose PHI about our clients'
patients, how our clients' patients can access and
copy that information, how our clients' patients may
request amendment of that information, and how our
clients' patients may request restrictions on our use
and disclosure of your PHI. Enhanced 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.
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.
Enhanced will use the medical information of our clients'
patients as part of billing for patient care rendered
by our clients. For example, when we submit a claim
to the insurance company of one of our clients' patients,
this claim contains medical information about the patient,
so that the claim may be paid by the insurance company.Uses
and Disclosure Enhanced may use and/or disclose the
protected health information or "PHI" of
patients of our clients, in accordance with federal
and state laws, for the following purposes:
Payment: We may use and disclose medical information
about you so that treatment and services our clients'
patients receive may be billed to and payment may be
collected from an insurance company, health plan, other
third party payor, or the patient. For example, we
may need to give the health plan of one of our clients'
patients a copy of the patient's medical information
so that the health plan will pay for the care, transportation
and treatment provided to the patient. When bills remain
unpaid, we may outsource these unpaid bills to one
or more collection agencies for processing and collection
of the bill.
Treatment: Our clients collect protected health information
in their course of treatment for their patients. We
may use this information to assist them in providing
the best possible care for their patients, and other
treatment, payment and health care purposes. This information
may be shared with other health care providers who
have treated the patient for that health care provider's
treatment, payment and health care operations purposes.
Health
Care Operations: We may use and disclose medical
information about our clients' patients for operations
purposes. These uses and disclosures are necessary
to make sure that we are following our policies correctly
and providing the best possible services we can for
our clients. For example, we may disclose information
to personnel for learning purposes. We may use protected
health information for educating clients and our own
personnel when discussing proper coding procedures.
We may (dependent upon the circumstances of a particular
situation) remove information that identifies a particular
patient from this set of medical information so that
others may learn from the information without learning
who specific patients are.
Other
Health Care Providers: We may disclose protected
health information about our clients' patients to other
health care providers for that health care provider's
treatment, payment and certain health care operations
purposes.
Business
Associates: We may disclose protected health
information to our own Business Associates or to the
Business Associates of our clients as the needs of
that Business Associate require.
Health
Care Fraud and Abuse Detection: We may disclose
protected health information for health care fraud
and abuse detection or for activities related to compliance
with the law.
As Required By Law: We will disclose medical information
about the patients of our clients when we are required
or permitted to do so under federal, state or local
laws.
To
Personal Representatives: We may disclose medical
information to a personal representative responsible
for the health care of a clients' patient, unless the
clients' patient objects.
To
a Family Member: We may disclose medical information
to a family member, other relative, or close personal
friend or other individual involved in the care of
a patient of our clients if we obtain the patient's
verbal agreement to do so or if we give them an opportunity
to object to such a disclosure and the patient does
not raise an objection or in situations where the patient
is not capable of objecting (because the patient is
not present or due to the patient's incapacity or medical
emergency).
Public
Health Authorities: We may disclose medical
information 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).
Health
Oversight Activities: We may disclose medical
information 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.
Law
Enforcement: We may disclose medical information
to law enforcement personnel as permitted by law 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.
Judicial
and Administrative Activities: We may disclose
medical information for judicial and administrative
proceedings as required by a court or administrative
order.
Military,
National Defense and Security Functions: We may disclose medical information for military, national
defense and security and other special government functions
as permitted by law;
Serious
Threats to Health or Safety: We may disclose
medical information to avert a serious threat to the
health and safety of a person or the public at large;
Workers'
Compensation: We may disclose medical information
for workers’ compensation purposes, and in compliance
with workers’ compensation laws;
Coroners,
Medical Examiners and Funeral Directors: We may disclose medical information 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;
Organ
Donations: If a patient is 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;
Research: We may disclose medical information 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 privacy
and adequate safeguards are in place in accordance
with the law;
Other
Uses and Disclosures: We may use or disclose
health information about you in a way that does not
personally identify you or reveal who you are. We may
also use or disclose health information about you as
otherwise permitted or required by law.
Any other use or disclosure of PHI, other than those
listed above will only be made with the written authorization
of the patient, (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). Patients may revoke their 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
Access: Patients of our clients have the right to
access their PHI. We have available forms for our clients'
patients to request access to their PHI and we or our
client will provide a written response if we (or our
client) deny the patient access and let the patient
know his or her appeal rights. We will also make every
attempt to accommodate patient requests for access
to PHI by alternative means or locations.
Copy
and Inspect: Patients of our clients have the
right to copy or inspect their PHI. This right is subject
to certain specific exceptions and patients may be
charged a reasonable fee for copies.
Amendments: Patients of our clients have the right
to amend their PHI. We will generally amend a patient's
information, if directed by our client, within 60 days
of the patient's request and will notify the patient
and the client who treated this patient when we have
amended the information. We and our clients are permitted
by law to deny a patient's request to amend the patient's
medical information only in certain circumstances,
like when we believe the information the patient has
asked us to amend is correct.
Accounting: Patients of our clients have the right
to an accounting of our uses and disclosures of their
PHI in the six years prior to the patient's request
to the client, except for disclosures for treatment,
payment or health care operations, and for certain
other specific disclosure types.
Restrictions: Patients of our clients have the right
to request that we restrict the uses and disclosures
of their PHI. But if a patients requests a restriction
and the information the patient asked us to restrict
is needed for our clients or other health care providers
to provide the patient with emergency treatment, then
we may use the PHI or disclosure the PHI to a health
care provider to provide you with emergency treatment.
Enhanced is not required to agree to any restrictions
a patient requests, but any restrictions agreed to
by Enhanced are binding on Enhanced.
Complaints: Patients of our clients have the right
to complain to our Privacy Officer and/or the U.S.
Department of Health and Human Services if they believe
we have violated their privacy rights.
Copies: Patients of our clients have the right to
obtain a copy of this Notice. If we maintain a web
site, we will make the Notice available electronically
through the web site. Otherwise, we will forward you
this Notice by electronic mail or a paper copy via
regular mail.
Enhanced reserves the right to modify the terms of
this Notice at any time. Changes are effective immediately.
Any material change to the Notice will be promptly
posted at our office and on our website, if one exists.
If you have any questions or if you are a patient of
one or more of our clients and wish to exercise any
rights listed in this Notice, please contact:
Joel B. Gum, Privacy Officer
Enhanced Management Services, Inc.®
243 Rooney Avenue
Danville, PA 17821
(570) 271-1120
Effective Date of the Notice:
April 14, 2003 |
