HIPAA Notice of Privacy Practices

Our Duty to Protect Your Health Information

SuperClass Car Service ("we" or "us") is a Non-Emergency Medical Transportation (NEMT) provider. As a Business Associate under HIPAA, we are required by law to maintain the privacy and security of your Protected Health Information (PHI), provide you with this notice of our legal duties and privacy practices, and follow the terms of this notice.

Protected Health Information We May Collect

In the course of providing NEMT services, we may collect and handle the following PHI:

• Your name, address, date of birth, and contact information
• Medicaid ID, Medicare ID, or other insurance identification numbers
• Medical appointment dates, times, and facility locations
• Information about mobility needs or medical conditions relevant to transportation
• Authorization and referral numbers from your healthcare provider or insurance plan

How We May Use and Disclose Your PHI

For Treatment: We may share your PHI with healthcare providers and medical facilities to coordinate your transportation to and from appointments.

For Payment: We may use and disclose your PHI to process claims with Medicaid, Medicare, or your insurance provider to obtain payment for NEMT services.

For Healthcare Operations: We may use your PHI for internal operations such as quality improvement, training, and compliance audits.

As Required by Law: We may disclose PHI when required by federal, state, or local law, including reporting to public health authorities or responding to court orders.

For Health and Safety: We may disclose PHI to prevent a serious threat to your health and safety or the health and safety of the public.

Your Rights Regarding Your PHI

You have the following rights:

• Right to Access: You may request a copy of the PHI we maintain about you. We will respond within 30 days.
• Right to Amend: You may request that we correct PHI that you believe is inaccurate or incomplete.
• Right to Restrict: You may request that we limit how we use or disclose your PHI, though we are not required to agree to all restrictions.
• Right to Accounting of Disclosures: You may request a list of certain disclosures we have made of your PHI.
• Right to Confidential Communications: You may request that we communicate with you in a specific way or at a specific location.
• Right to a Paper Copy: You may request a paper copy of this notice at any time.

Our Responsibilities

• We are required to maintain the privacy and security of your PHI
• We will notify you promptly if a breach occurs that may have compromised your PHI
• We will not use or disclose your PHI for marketing purposes without your written authorization
• We will not sell your PHI
• We train our employees and drivers on HIPAA privacy and security requirements

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or with the U.S. Department of Health and Human Services Office for Civil Rights. We will not retaliate against you for filing a complaint.

File a complaint with HHS:
U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
1-877-696-6775
www.hhs.gov/ocr/privacy/hipaa/complaints/

Privacy Officer Contact

For questions about this notice or to exercise your rights, contact our Privacy Officer:
SuperClass Car Service
1831 Grand Concourse, Bronx, NY 10453
Phone: (718) 367-2222
Email: [email protected]

Changes to This Notice

We reserve the right to change this notice and make the new provisions effective for all PHI we maintain. A current copy will always be available on our website and at our office.