Effective Date: June 2022
This notice describes how your medical information may be used and disclosed, as well as how you can get access to this information. Please read it carefully. If you have any questions about this notice, please call us at 507-452-5351.
Winona Area Ambulance Service (WAAS), Inc. is required by law to maintain the privacy of protected healthcare information (PHI) and to provide you with a notice of our privacy practices . This describes your rights, advises you of how WAAS may use and disclose PHI. WAAS is required to abide by the terms of this notice currently in effect. We may use PHI, in situations as described in this notice, without your permission. However, there are some situations where we may use the information only after we obtain your written authorization, if we are required by law to do so.
Our Uses and Disclosures:
Except for the purposes described below, Winona Area Ambulance Service, Inc. (WAAS) will use and disclose you protected health information (PHI) only with your written permission. WAAS does not sell or rent patient’s names or addresses to any organization.
- Treatment, health care operations, and coordination of care
- In-house administrative work or trainings
- Billing, insurance, or collections
- Public health, public safety, or disaster relief
- Scientific research
- Organ & tissue donation requests
- Medical examiner or funeral director requests
- Work comp, law enforcement, military, or government requests
- Lawsuits & legal actions
- Individuals involved in your care or finances
You have a choice regarding how we share you information in the situations listed below. If you are unable to agree or object to such a disclosure, we may disclose such information if it is in your best interest, based on our professional judgment.
- WAAS may disclose to a relative, a close friend, or any other person you identify, your PHI that directly relates to that person’s involvement in your health care.
- WAASmay also disclose your PHI to disaster relief organizations that seek your PHI to coordinate your care, or notify family and friends of your location or condition in a disaster.
You may revoke your consent to disclose your PHI at any time by submitting a written revocation to our Privacy Officer. Disclosures made prior to your revocation will not be affected.
You have the following rights regarding your PHI:
- Right to Inspect and Copy Your Records. For a copy of your ambulance record, a request must be made in writing. WAAS has up to 30 days to make your records available to you and may deny the request in certain limited circumstances. Any denial will be in writing. WAAS may charge a reasonable fee for copies.
- Right to Amend. If you feel that your PHI is incorrect or incomplete, you may ask us to amend the information. To request an amendment, you must make your request, in writing. If we deny your request, it will be in writing within 60 days.
- Right to an Accounting of Disclosures. You have the right to request a list of certain disclosures we made of PHI for purposes other than treatment, payment and health care operations or for which you provided written authorization. Requests must be made in writing, and are only applicable for the six years prior to the date of the request.
- Right to a Paper Copy of This Notice.
- Right to a Medical Power of Attorney.
- Right to Request Restrictions. You have the right to request a restriction or limitation on the PHI that WAAS uses or discloses for treatment, payment, or health care operations. All requests must be made in writing. We may deny this request in writing if it would be harmful or compromise your care. If you pay for a service out-of-pocket in full, you have the right to request that we not disclose that information for the purpose of payment with your health insurance.
- Right to File a Complaint. You can file a complaint by contacting us by phone or mail. You may also file a complaint with the US Dept. of Health and Human Services, Office for Civil Rights at 200 Independence Ave SW, Washington DC 20201 or by calling 1-800-368-1019.
- We will abide by federal and state laws requiring us to protect your PHI.
- We will notify you if any breach occurs that compromises your PHI.
- We will abide by the privacy practices outlined in this document and provide you with a copy.
Changes to our Privacy Practices:
Winona Area Ambulance Service, Inc. reserves the right to change this notice. Any updates will apply to PHI that WAAS already maintains, as well as any information we receive in the future. WAAS will keep the most updated Notice of Privacy Practices posted on our website: winonaambulance.com.
You can file a complaint by contacting us by phone or mail. You may also file a complaint with the US Dept. of Health and Human Services, Office for Civil Rights at 200 Independence Ave SW, Washington DC 20201 or by calling 1-800-368-1019. You will not be penalized for filing a complaint.
Our Contact Information:
For complaints, concerns, inquiries, or requests to our privacy officer you may contact Winona Area Ambulance Service by phone at 507-452-5351, fax at 507-452-0764, or mail at 370 W 2nd St, Suite 300, Winona, MN 55987.