Pinnacle Ambulance Services - HIPPA Privacy Policy

This Notice describes how medical information about you may be used and disclosed and how you may obtain access to this information. Please review it carefully.

This Notice tells you about the ways in which Pinnacle Ambulance Service (referred to collectively in this Notice as “we” or “Pinnacle”), may use and disclose your protected health information and your rights concerning your protected health information. “Protected health information” is information about you, including demographic information, that can reasonably be used to identify you as that relates to your past, present or future physical or mental health or condition, the provision of health care to you or the payment for that care.

We are required by a federal law, called the Health Insurance Portability and Accountability Act of 1996 (referred to as HIPAA), to provide you with this Notice about your rights and our legal duties and privacy practices with respect to your protected health information. We must follow the terms of this Notice while it is in effect. It’s important to note that some of the uses and disclosures described in this Notice may be limited in certain cases by applicable state laws that are more stringent than the federal standards.

You have certain rights regarding protected health information that Pinnacle maintains about you.

Right to Access Your Protected Health Information. You have the right to review or obtain copies of your protected health information records, with some limited exceptions. Your request to review and/or obtain a copy of your protected health information records must be made in writing. We may charge a fee for the costs of producing, copying and mailing your requested information, but we will notify you of the cost in advance.
Right to Amend Your Protected Health Information. If you feel that protected health information maintained by Pinnacle is incorrect or incomplete, you may request that we amend the information. Your request must be made in writing and must include the reason you are seeking a change. We may deny your request if, for example, you ask us to amend information that was not created by Pinnacle or you ask to amend a record that is already accurate and complete. If your request to amend is denied, we will notify you of our decision in writing. You then have the right to submit to us a written statement of disagreement with our decision and we further have the right to rebut that statement.
Right to an Accounting of Disclosures by Pinnacle. You have the right to request an accounting of disclosures we have made of your protected health information. The list will not include our disclosures made for treatment, payment or health care operations, or disclosures made to you or with your authorization. The list may also exclude certain other disclosures, such as for national security purposes.
Your request for an accounting of disclosures must be made in writing and must state a time period for which you want an accounting. This time period may not be longer than six years and may not include dates before April 14, 2003. The first accounting requested within a 12-month period will be provided free of charge. For additional lists within the same time period we may assess a fee for providing the accounting, but will notify you of the cost in advance.
Right to Request Restrictions on the Use and Disclosure of Your Protected Health Information. You have the right to request that we restrict or limit how we use or disclose your protected health information for treatment, payment or health care operations. We may not agree to your request. If we do agree, we will comply with your request unless the information is needed for an emergency. Your request for a restriction must be made in writing. In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit how we use or disclose your information, or both; and (3) to whom you want the restrictions to apply.
Right to Receive Confidential Communications. You have the right to request that we use a certain method to communicate with you or that we send information to a certain location. Your request to receive confidential communications must be made in writing. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.
Right to a Paper Copy of This Notice. You have a right at any time to request a paper copy of this Notice even if you have previously agreed to receive an electronic copy.