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HIPAA Privacy Statement This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully. Walton County EMS is required by law to maintain the privacy or certain confidential health care information, known as Protected Health Information or, PHI, and to provide you with a notice of our legal duties and privacy practices with respect to your PHI. This Notice describes your legal rights, advises you of our privacy practices, and lets you know how Walton County EMS is permitted to use and disclose PHI about you. Walton County EMS is required to abide by the terms of the version of this Notice currently in effect. Use and Disclosures of PHI: Walton County EMS may use PHI for the purposes of treatment, payment and health care operations, in most cases without your written permission. Any other use or disclosure of PHI 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. 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. For treatment; this includes such things as obtaining verbal and written information about your medical condition and treatment from you as well as from others, such as doctors and nurses who give orders to allow us to provide treatment to you. For payment; this includes any activities we must undertake in order to get reimbursed for the services we provide to you, including such things as submitting bills to insurance companies, making medical necessity determinations and collecting outstanding accounts. For health care operations; this includes quality assurance activities, licensing, and training programs to ensure that our personnel meet our standards of care and follow established policies, as well as certain other management functions. Use and Disclosure of PHI Without Your Authorization. Walton County EMS permitted to use PHI without your written authorization, or opportunity to object, as required by law, or in certain situations, unless prohibited by a more stringent state law, including: For the treatment, payment or health care operations activities of another health care provider who treats you; For health care and legal compliance activities; 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 too such a disclosure and you do not raise an objection, and in certain other circumstances where we are unable to obtain your agreement and believe the disclosure is in your best interests; To a public health authority in certain situations as required by law, such as to report abuse, neglect or domestic violence; For health oversight activities including audits or government investigations, inspections, disciplinary proceedings, and other administrative or judicial actions undertaken by the government (or their contractors) by law to oversee the health care system; For judicial and administrative proceedings as required by a court or administrative order, or in some cases in response to a subpoena or other legal process; For law enforcement activities in limited situations such as when responding to a warrant; For military, national defense and security and security and other special government functions; To avert a serious threat to the health to the health and safety of a person or the public at large; ---PAGE BREAK--- 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; For research projects, but this will be subject to strict oversight and approvals; We may also use or disclose health information about you in a way that does not personally identify you or reveal who you are. Any other use or disclosure of PHI, other listed above will only be made with your written authorization. You may revoke your authorization at anytime, in writing, except to the extent that we have already used or disclosed medical information in reliance on that authorization. Patient Rights: As a patient, you have a number of rights with respect to the protection of your PHI, including the right to access, copy or inspect your PHI, the right to amend your PHI, the right to request an accounting of our use and disclosure of you PHI, the right to request that we restrict the uses and disclosures of your PHI, and the right to obtain copy of Notice on request. Revisions to the Notice: Walton County EMS reserves the right to change the terms of this Notice at any time, and the changes will be effective immediately and will apply to all protected health information that we maintain. Any material changes to the Notice will be posted in our facilities. You can get a copy of the latest version of this Notice by contacting the Privacy Officer identified below. Your Legal Rights and Complaints: You have the right to complain to us, or to the Secretary of the United States Department of Health and Human Services if you believe your privacy rights have been violated. You will not be retaliated against in any way for filing a complaint with us or to the government. Should you have any questions, comments or complaints you may direct all inquiries to the privacy officer listed at the end of this Notice. For questions about this notice or your account, please call: (770) 266 - 1690