​HIPPA Notice of Privacy Practices
Effective 11/01/2025
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Edwards Ambulance, Inc.
3440 Oneida Street, PO Box 130
Chadwicks, NY 13319
Phone (315) 737-7657

Edwards Ambulance, Inc. herein referred to as Edwards, is committed to protecting your personal health information. We are required by law to maintain the privacy of health information that could reasonably be used to identify you, known as “protected health information” or “PHI.” We are also required by law to provide you with the attached detailed Notice of Privacy Practices (“Notice”) explaining our legal duties and privacy practices with respect to your PHI.

We respect your privacy, and treat all healthcare information about our patients with care under strict policies of confidentiality that our staff is committed to at all times.
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Please read the attached detailed notice. If you have any questions about it, please contact Stephanie Jennings, our HIPAA Compliance Officer, at (315) 737-8735.

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED OR  DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.  PLEASE REVIEW IT CAREFULLY.

Purpose of This Notice: This Notice of Privacy Practices describes your legal rights, advises you of our privacy practices, and lets you know how we may use and disclose your protected health information (PHI) to carry out treatment, payment or healthcare operations, and for other purposes that are permitted or required by law.  It also describes your rights to access and control your protected health information. 

Uses and Disclosures of Protected Health Information
Your protected health information may be used and disclosed by your physician, our office staff, and others outside of our office that are involved in your care and treatment for the purpose of providing health care services to you, to pay your health care bills, to support the operation of the physician’s practice, and any other use required by law. Edwards may use and disclose your PHI without your authorization or without providing you the opportunity to object, for the following purposes:

Treatment: This includes 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 and allow us to provide treatment to you). It also includes information we give to other healthcare personnel that we transfer your care and treatment to. This includes transfer of PHI via radio, telephone or Pulsara to the hospital or dispatch center as well as providing the hospital with a copy of the written record we create in the course of providing your treatment and transport.   

Payment: Your PHI will be used, as needed, to obtain payment for the services provided to you.   For example, submitting bills to insurance companies (either directly or through a third-party billing company) collecting outstanding payments, managing billed claims, performing medical necessity determinations and reviews and performing utilization reviews.  

Healthcare Operations:   This includes, but is not limited to, quality assurance activities, licensing, training programs that ensure our employees meet our standard of care and follow policies and procedures, employee review activities, training of medical students, and conducting or arranging for other business activities such as processing grievances and complaints, creating reports that do not identify you for data collection purposes and certain marketing 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 and medical transportation, or for other information about alternative services we provide or other health related benefits and services we provide that may be of interest to you.

Other Uses and Disclosure of Your PHI We Can Make Without Authorization:

• For the treatment activities of another healthcare provider;
• To another healthcare provider or entity for the payment activities of the provider or entity that receives the information (such as your hospital or insurance company)
• To another healthcare provider (such as the hospital to which you are transported) for the healthcare operations activities of the entity that receives the information as long as the entity receiving the information has or has had a relationship with you and the PHI pertains to that relationship;
• For healthcare fraud and abuse detection or for activities related to compliance with the law;
• To a family member, other relative, or close personal friend or other individual involved in your care if we obtain your verbal agreement to do so or if we give you an opportunity to object to such a disclosure and you do not raise an objection. We may also disclose health information to your family, relatives, or friends if we infer from the circumstances that you would not object. For example, we may assume that you agree when your spouse has called the ambulance for you. In situations where you are incapable of objecting (because you are not present or due to your incapacity or medical emergency), we may, in our professional judgement, determine that a disclosure to your family member, relative, or friend is in your best interest.  In that situation, we will disclose only information that is relevant to that person’s involvement in your care. For example, we may inform the person who accompanied you in the ambulance that you have certain symptoms and we may give that person an update on your vital signs and treatment that is being administered by our ambulance crew;
• 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 or 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 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 of a person or the public at large;
• For workers’ compensation purposes, and in compliance with workers’ compensation laws;
• 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 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; and
• For research projects, but this will be subject to strict oversight and approvals and 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.

Uses and Disclosures of Your PHI That Require Your Written Consent
Any uses or disclosures of your PHI, other than those listed above, will only be made with your written authorization (the authorization must specifically identify the information we seek to use or disclose, as well as when and how we seek to use or disclose it). Specifically, we must obtain your written authorization before using or disclosing your: a) psychotherapy notes, other than for the purpose of carrying out your own treatment, payment or health care operations purposes, b) PHI for marketing when we receive payment to make a marketing communication; or c) PHI when engaging in a sale of your PHI. You may revoke your authorization at any time, in writing, except to the extent that we have already used or disclosed medical information in reliance on that authorization.

Your Rights Regarding Your PHI
As a patient, you have a number or rights with respect to your PHI. These rights include:

Right to access, copy or inspect your PHI: You have the right to inspect and copy most of the medical information that we collect and maintain about you. Requests for access to your PHI should be made in writing to our HIPAA Compliance Officer. In limited circumstances, we may deny you access to your medical information, and you may appeal certain types of denials. We have available forms to request access to your PHI, and we will provide a written response if we deny you access and let you know your appeal rights. If you wish to inspect or copy your medical information you should contact our Office at (315) 737-8735 or mail your request to Edwards Ambulance, Inc. 3440 Oneida Street, PO Box 130, Chadwicks, NY 13319
We provide you with access to this information in a timely manner upon receipt of your written request. If we maintain information in electronic format, they you have a right to obtain a copy of that information in an electronic format. In addition, if you request that we transmit a copy of your PHI to another person, we will do so provided that your request is in writing, signed by your (or your representative), and you clearly identify the designated person and location of where to send the copy of your PHI.
We may also charge you a reasonable cost-based fee for providing you access to your PHI, subject to the limits of New York State Law.

Right to request an amendment of your PHI: You have a right to request us to amend PHI that we maintain about you. Requests should be made in writing to Edwards Ambulance, Inc. 3440 Oneida Street, PO Box 130, Chadwicks, NY 13319.
When required to do so by law, we will amend your information within 60 days of your request and will notify you when we have amended the information. We are permitted by law to deny your request in certain circumstances, such as when we believe that the information you have asked us to amend is correct.

Right to request Restrictions: You have a right to request to restrict how we use and disclose your PHI for treatment, payment, or healthcare operation purposes, or to restrict the information provided to your family, friends and others involved in your healthcare. To request a restriction please notify us in writing at the address listed at the top of this policy. We are not required to agree to your request for restriction. If we do agree to your restriction we will abide by it but may still use the information in certain emergency treatment situations.

Right to Request Confidential Communications: You have a right to request that we communicate with you at a certain location or in a certain way. For example, you can request we only contact you by mail or by a work phone number. To make a request for confidential communication please send us your request in writing to Attn: Stephanie Jennings at the address listed on the first page. Please specify how (by phone / by mail and where what address / phone number) you would like to be contacted. We will accommodate all reasonable requests.

Right to Notice of a Breach of PHI: In the event we discover that there has been a breach of PHI, we will notify you about the breach by first class mail to the most recent address we have on file.

Website Posting and Right to Obtain Paper Copy of This Notice: If we have an active website this privacy notice will be posted to the section titled Notice of Privacy Practices. At your request we can email you a copy of this notice or you can request a paper copy.
Changes to this Notice: We reserve the right to revise or change the terms of this notice. Changes or revisions made will be effective to information we already have as well as information we may receive in the future. We will post the current notice on our website and will have paper copies available at our office. The effective date will be displayed on the first page of this notice.

Complaints: If you believe your privacy rights have been violated, you may file a complaint with us or the Secretary of the United States Department of Health and Human Services. To file a complaint with us please send it in writing to the attention of our HIPAA Compliance Officer Stephanie Jennings at the address listed on the first page.  You will not be retaliated against for filing a complaint.