We have had a few questions regarding the release of protected health information (PHI) under HIPAA. When can you release PHI without the patient's written consent? Think TPO!

Treatment: This includes such things as obtaining verbal and written information about your patient's medical condition and treatment from them as well as others, such as doctors and nurses and family members. You may give PHI to other health care providers involved in their treatment and you may transfer PHI via radio or telephone to the hospital or dispatch center.

Payment: This includes any actions that you or we must take in order to get reimbursed for the services you provide. This can be such things as submitting bills to insurance companies and collecting outstanding accounts.

Operations: This can include quality assurance audits, licensing, training and other management functions.

For a response to be emergent the call must first be dispatched 911 or equivalent and the ambulance provider must begin as quickly as possible to take the steps necessary to respond to the call. The use of lights and sirens alone doesn't constitute an emergency. It is therefore extremely important that you always note the nature of dispatch, response mode and level of service dispatched on each and every MIR.

"Medic 12 responded immediately to a 911 ALS dispatch for chest pain"

Remember that if you did not take immediate steps to respond, you can still bill the patient for the level of service they received but you may no longer bill it as emergent. Documenting the level of dispatch is also critical when upcoding a BLS service to ALS with the use of the ALS Assessment (See July '04 Newsletter).

As part of their own internal audit, Marysville Fire came to our office last week to audit us. Their goal was to randomly select a number of transports and follow them completely through our process and examine all relevant documentation. I am happy to say that we passed with flying colors.
Accuracy is very important to us. Every client is balanced every day. If for some reason something doesn't balance, we investigate until the problem is resolved. 'Close enough' is not in our vocabulary. We welcome any client to our office to review our procedures or audit our records.

Judy Dunn
- Account Manager
In this section we like to introduce you to some of our employees. We have selected to profile Judy in this issue because she has celebrated a major milestone this month. That's right, Judy has become a grandmother! Her daughter Nichole and son-in-law Robert are the proud parents of a beautiful baby boy.

Judy has been with Systems Design for almost six years. Previously she was the office manager for a local physician, so she came on board with lots of experience.

When Judy is not working, she can often be found in her garden, workshop or at her church where she and her husband sing in the choir. Next time you are on the phone with her, be sure to congratulate the new 'Granny'.

A police officer pulls a guy over for speeding and has the following exchange: Officer: May I see your driver's license? Driver: I don't have one. I had it suspended when I got my 5th DUI. Officer: May I see the owner's card for this vehicle? Driver: It's not my car. I stole it. Officer: The car is stolen? Driver: That's right. But come to think of it, I think I saw the owner's card in the glove box when I was putting my gun in there. Officer: There's a gun in the glove box? Driver: Yes sir. That's where I put it after I shot the woman who owns this car and stuffed her in the trunk. Officer: There's a BODY in the TRUNK?!?!? Driver: Yes, sir. Hearing this, the officer immediately called his captain. The car was quickly surrounded by police, and the captain approached the driver to handle the tense situation: Captain: Sir, can I see your license? Driver: Sure. Here it is. It was valid. Captain: Who's car is this? Driver: It's mine, officer. Here's the registration. Captain: Could you slowly open your glove box so I can see if there's a gun in it? Driver: Yes, sir, but there's no gun in it. Sure enough, there was nothing in the glove box. Captain: Would you mind opening your trunk? I was told you said there's a body in it. Driver: No problem. Trunk is opened; no body. Captain: I don't understand it. The officer who stopped you said you told him you didn't have a license, stole the car, had a gun in the glove-box, and that there was a body in the trunk? Driver: Yeah, and I'll bet the big liar told you I was speeding too!

Although we always welcome your phone calls, there are times you may wish to contact us via e-mail.

Lori Christenbury	LoriC@SystemsDesignNW.com
Shelley Brewington	ShelleyB@SystemsDesignNW.com
Cris Connors	CrisC@SystemsDesignNW.com
Judy Dunn	JudyD@SystemsDesignNW.com
Tammy Flanagan	TammyF@SystemsDesignNW.com
Carol Green	CarolG@SystemsDesignNW.com
Laurel Hoch	LaurelH@SystemsDesignNW.com
Sue Holler	SueH@SystemsDesignNW.com
Kim Mayes	KimM@SystemsDesignNW.com
Lois Pierce	LoisP@SystemsDesignNW.com
Lisa Rogalsky	LisaR@SystemsDesignNW.com
Juls Smith	JulsS@SystemsDesignNW.com
Cindy Tomeo	CindyT@SystemsDesignNW.com
Susan Wytko	SusanW@SystemsDesignNW.com
Roger Zegers	RogerZ@SystemsDesignNW.com

November
11th Veterans Day - Open
24th Thanksgiving - Closed
25th Thanksgiving - Closed

December
23rd Christmas - Close at noon
26th Christmas - Closed

January
2nd New Years - Closed