City of Carrollton
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.
The City of Carrollton is committed to protecting your personal health information. We are required by law to maintain the privacy of health information that could reasonably be used to identify you, known as “protected health information” or “PHI”. We are also required by law to provide you with the attached detailed Notice of Privacy Practices (“Notice”) explaining our legal duties and privacy practices with respect to your PHI.
We respect your privacy, and treat all healthcare information about our patients with care under strict policies and confidentiality that our staff is committed to following at all times.
Please read the detailed notice. If you have any questions about it, please contact the EMS Chief, our HIPAA compliance officer, at 972-466-3393 or 972-466-3070.
Detailed Notice of Privacy Practices
Purpose of This Notice: This Notice describes your legal rights, advises you of our privacy practices, and lets you know how the City of Carrollton is permitted to use and disclose PHI about you.
Uses and Disclosures of Your PHI We Can Make Without Your Authorization
The City of Carrollton may use or disclose your PHI without your authorization, or without providing you with an opportunity to object, for the following purposes:
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 healthcare 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.
Payment. This includes any activities we must undertake in order to get reimbursement for the services that we provide to you, including such things as organizing your PHI, submitting bills to insurance companies (either directly or through a third party billing company), managing billed claims for services rendered, performing medical necessity determinations and review, performing utilization reviews, and collecting outstanding accounts.
Healthcare Operations. This includes quality assurance activities, licensing, and training programs to ensure that our personnel meet out 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 the City of Carrollton, or to provide you with information about our annual subscription program.
In addition, we may use your PHI for certain fundraising activities. For example, we may use PHI that we collect about you, such as your name, home address, phone number or other information, in order to contact you to raise funds for our agency. We may also share this information with another organization that may contact you to raise money on our behalf. If the City of Carrollton does use your PHI to conduct fundraising activities, you have the right to opt out of receiving such fundraising communications from the City of Carrollton, if you do not want to be contacted for our fundraising efforts, you should contact , the EMS Chief, our HIPAA Compliance Officer, in writing, by phone or by e-mail. Contact information for our HIPAA Compliance Officer is listed at the end of this Notice. We will also remind you of this right to opt out of receiving future fundraising communications every time that we use your PHI to conduct fundraising and contact you to raise funds. The City of Carrollton will not condition the provision of medical care on your willingness, or non-willingness, to receive fundraising communications.
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.
Other Uses and Disclosures of Your PHI We can Make Without Authorization
The City of Carrollton is also permitted to use or disclose your PHI without your written authorization in situations including:
City of Carrollton, 1945 E. Jackson Road, Carrollton, Texas 75006 | Tel: (972) 466-3000 | Site Map
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