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
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.
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:
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.
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.
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
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
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
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.
LifeStar Response Corp.
3710 Commerce Drive
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.