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Patient Information Guide

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DICLOSED AND HOW YOU MAY GET ACCESSS TO THIS INFORMATION.  PLEASE READ IT CAREFULLY.

Purpose of This Notice: LifeStar Response Corporation is required by law to maintain the privacy of certain confidential health care information, known as Protected Health Information (PHI).  We are required to provide notice to you of our legal duties and privacy practices with respect to your PHI.  This notice describes your legal rights, advises you of our privacy practices and lets you know how LifeStar Response Corporation is permitted to use and disclose PHI about you.  LifeStar Response Corporation is also required to abide by the terms of the version of this notice currently in effect.  We may use information after we obtain your consent and in emergency situations without your immediate consent.

Uses and Disclosures of PHI: LifeStar Response Corp. may use PHI for the purposes of treatment, payment and other healthcare operations.  Examples of our use of your PHI include:

For 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 health care personnel to whom we transfer your care and treatment, and includes transfer of PHI via radio or telephone to the hospital 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.

For Payment: This includes any activities we must undertake in order to be reimbursed for services we have provided to you inclusive of organizing your PHI and submission of bills to insurance companies (either directly or through a third party billing company), management of billed claims for services rendered, medical necessity determinations and reviews, utilization review and collection of outstanding accounts.

For Health Care Operations: This includes quality assurance activities, licensing, and training programs to ensure our personnel meet our 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 and certain other activities.

Reminders for Scheduled Transport and Information on Other Services: We may contact you to provide you with a reminder of any scheduled appointments for non-emergency ambulance or ambulette transportation, or for other information about alternative services we may provide or other health related benefits and services that may be of interest to you.

Use and Disclosure of PHI Without Your Consent: LifeStar Response Corporation is authorized to use your PHI without your consent, authorization, or written permission in certain situations, including;

·         Emergency situations, (in these situations and in accordance with the law we will attempt to get your written consent after the emergency service is provided and we would appreciate your cooperation when we do so);

·         To a relative, friend or individual in your care;

·         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 abuse, adult abuse, 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.

·         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 there is a warrant for the request or when the information is needed to locate a suspect or stop a crime.

·         For military, national defense and security and other special government functions;

·         To avert a serious threat to the health and safety to a person or the public at large;

·         For Workers’ Compensation purposes, in compliance with the applicable Workers’ Compensation Law;

·         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.

·         If you are an organ donor, we may release health information to the 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;

·         For research projects, but this will be subject to strict oversight and approvals.  Health information will be released only when there is a minimal risk to your privacy and adequate safeguards are in place in accordance with the law;

·         We may use or disclose health information about you in a way that does not personally identify you or reveal who you are;

If you have any additional questions concerning the use of your PHI, please contact the Lifestar Representative below.

Charles Boone
LifeStar Response Corp.
3710 Commerce Drive
Suite 1006
Baltimore, Maryland 21227

This notice updated: February 27, 2008

We will revise this notice if we make material changes to it.  You can get a copy of the latest version of this notice by contacting the Privacy officer or any staff member.