|
Privacy Policy
Air Ambulance Card® online credit card transactions are processed securely through VeriSign. No complete record of the member’s credit card information is received by Air Ambulance Card and no credit card information is provided by Air Ambulance Card to other companies or organizations. Air Ambulance Card records contain only the credit card type, card holder’s name, and the last four digits of the card number and expiration date.
This notice describes the health information practices of Air Ambulance Card and the Air Ambulance Card Membership Program. It describes how health information about you may be used and disclosed and how you can get access to this information.
Please review it carefully
This Privacy Notice gives you information required by the privacy provision of Health Insurance Portability and Accountability Act of 1996 and its implementing regulations (HIPAA Privacy Rules) about the duties and privacy practices of Air Ambulance Card. Air Ambulance Card is committed to respect patient privacy and protect confidential patient information. This Notice of Privacy Practices is required under the HIPAA Privacy Rules and describes your privacy rights and explains the ways in which we may share your health information with others.
We are required to follow the terms of this notice until we replace it, and we reserve the right to change the terms of this notice at any time. If we make changes, we will revise it and send a new Privacy Notice to all persons to whom we are required to give the new notice. We reserve the right to make the new changes apply to all your medical information maintained by us before and after the effective date of the new notice. If you do not understand the terms of this Notice, please ask for further explanation.
This Notice applies to all the records of your care generated by Air Ambulance Card. This notice describes the practices of Air Ambulance Card and its healthcare professionals authorized to enter information into your records. This Notice includes employees, medical personnel (as described in the health information sharing arrangement set forth in HIPAA), students, and other authorized individuals and companies.
We understand that health information about you is personal and must be properly safeguarded. Air Ambulance Card pledges to use or disclose your health information as required or permitted by law. We promise to respect your privacy rights and comply will all applicable privacy laws.
Although your medical record is the physical property of Air Ambulance Card, the information belongs to you.
At Air Ambulance Card, you have the right to:
- Ask that we limit how we use and disclose your health information. You have the right to request in writing a restriction of your health information. You may not be able to limit the uses and disclosures required by law.
- Choose how we send your health information to you. You have the right to request in writing for your health information to be sent by different means or to different locations. We must agree to your request if it can be met reasonably.
- Right to see and receive copies of your health information. You have the right to request in writing to see and receive copies of your health information. You will be responsible for any and all applicable charges for copies and mailing. In limited cases, we do not have to agree to your request. If we are unable to meet your request, we will send you our reason in writing and you can request a review.
- Receive a list of the instances in which we have disclosed your health information. You have the right to request in writing a record of certain disclosures of your health information. There may be restrictions that apply.
- Amend your health information. You have the right to request in writing that we amend your health information if you feel the information is incomplete or incorrect. You must also provide the reason. If we are unable to meet your request, we will send you our reason in writing and you can request a review.
- Request a paper copy of this Notice at any time. You have the right to request a paper copy of this Notice at any time. You can also check the Air Ambulance Card website at www.AirAmbulanceCard.com
- Revoke your authorization to use or disclose your health information. You have the right to revoke your authorization, except to the extent action has already been taken on it.
Air Ambulance Card is required to:
- Maintain the privacy of your health information
- Provide you with this Notice as to our legal duties and privacy practices with respect to safeguarding your health information
- Comply with the terms of this Notice
- Notify you if we are unable to meet your request under this Notice
- Accommodate reasonable requests you may have to communicate your health information by different means or to different locations
Examples of how we will use and disclose your health information:
- Treatment: We will use and disclose your health information recorded by a nurse, physician, or other member of your healthcare team to determine the best course of treatment for you. This will also enable your healthcare team to review the treatment you have received and how you are responding.
- Payment: We will use and disclose your health information on a bill sent to you, your insurance company, or other paying entities which include information that identifies you, your diagnosis, procedures, and supplies used to care for you.
- We will use and disclose your health information to assess care during medical consultation, medical referral, medical monitoring, and/or air medical transport and to carry out routine business functions.
- Follow-up: We may use your health information to contact you for a follow-up after a transport, medical referral, or medical consultation.
- Treatment Options: We will use and disclose your health information recorded by a nurse, physician, or other member of your healthcare team while discussing with you possible treatment/transport options, alternatives, and other health-related matters as they relate to your condition and past history.
- As required by law: We may use and disclose your health information when required to do so by federal, state, or local law, including abuse or neglect.
- Business Associates: We may use and disclose your health information to our business associates to enable them to perform the job we asked them to do. They must appropriately safeguard your health information.
- For Public Health and Safety: We may use and disclose your health information as appropriate to a health oversight agency or individual charged with controlling disease, injury, or disability or preventing a risk to public health and safety. This may include the US Food and Drug Administration or the State Health Department.
- Law Enforcement and Litigation: We may use and disclose your health information for law enforcement purposes or litigation as required by law, in response to a valid subpoena or other court order.
- Marketing: We may use and disclose your health information to solicit funds to benefit Air Ambulance Card. This will require written authorization by you. We would only release your contact information, such as name, address, phone number, and dates of service. If you do not want Air Ambulance Card to contact your for marketing efforts, you must notify us in writing.
- Flight Schedules and Whiteboards: We may disclose your health information on flight schedules and whiteboards to facilitate plane and crew schedules and medical personnel communications.
- Notification: For minor patients, we may use or disclose health information to a parent or legal guardian. For adult patients, we may use or disclose health information to notify a family member, personal representative, or another person responsible for your care.
Complaints:
If you believe your privacy rights have been violated, please contact us at:
Air Ambulance Card, LLC
2 North 20th Street
Suite 1300
Birmingham, AL 35203
(205) 297-0060 Phone
(205) 297-0065 Fax
You can also file a complaint with the Office of Civil Rights, Secretary of the US Department of Health and Human Services.
Other Uses of Your Health Information:
We will not use or disclose your health information, without your permission/authorization, except as described in this Notice or as required by law. You may authorize disclosure for other purposes by completing a written authorization that meets the requirements of the law. You may revoke such authorization in writing at any time.
Effective Date:
This notice is effective as of July 1, 2004.
To request additional copies of this notice or to receive more information about our privacy practices to your rights, please contact us at the following:
Air Ambulance Card, LLC
Attn: Samuel Jackson, Privacy Officer
2 North 20th Street
Suite 1300
Birmingham, AL 35203
(205) 297-0060 Phone
(205) 297-0065 Fax
Email: sjackson@AirAmbulanceCard.com