NOTICE OF PRIVACY PRACTICIES (NPP)

Uses and Discloser of Personal Health Information (PHI)

This NPP describes how Tipp City EMS may use and disclose your PHI to carry out treatment,  payment or health care operations and for other purposes that are permitted or required by law. We may use PHI for the purposes of treatment, payment, health care operations and when required by law for; public health, communicable disease control, health oversight, abuse or neglect, legal proceedings, law enforcement, coroners activity, criminal activity, military activity, national security, workers’ compensation, inmate activity, Food and Drug Administration activity and United States Department of Health and Human Services activity. Any other use or disclosure of PHI will only be made with your written authorization and must include which information may be disclosed and how it is to be disclosed.

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 the authorization.

You have the right to copy or inspect your PHI within thirty days of your request do to so. We may charge reasonable fees for copies made of your PHI.You may amend your PHI by providing Tipp City EMS with the amended information. Amendments will be made within sixty days unless the amended information is deemed to be incorrect or false. You will be notified if this is the case.

You may request to know who has been supplied with your PHI by Tipp City EMS.

You may restrict the uses and disclosers of your PHI except that which is necessary for emergency treatment.

You may obtain a copy of this notice through the internet or electronic mail.

You may complain to us or to the Secretary of the United Sates Department of Health and Human Services if you believe that your rights have been violated. Tipp City EMS may change the terms of our notice at any time. The new notice will be in effect for all PHI that we maintain at the time. Upon request, we will provide you with any revised NPP by calling the office and requesting a copy be sent to you in the mail.

If you have any questions, wish to file a complaint or exercise any rights listed in this notice, please contact Chief Mark Senseman, Tipp City EMS Division, 260 S. Garber Dr., Tipp City, Ohio, 45371. Effective 14 April 2003.