Notice of Privacy Practices (HIPAA)

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.

I. Our Pledge Regarding Medical Information

At Daystar EMS Inc., we understand that medical information about you and your health is personal. We are committed to protecting medical information about you. We create a record of the care and services you receive from our team of EMTs and Paramedics to provide you with quality patient care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by Daystar EMS Inc., whether made by our clinical staff or our administrative billing office.

II. How We May Use and Disclose Your Protected Health Information (PHI)

The following categories describe different ways that we use and disclose medical information. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.

1. For Treatment We may use medical information about you to provide you with medical treatment or services. We may disclose medical information about you to doctors, nurses, technicians, medical students, or other personnel who are involved in taking care of you. For example, a Paramedic may need to tell the emergency room physician about your heart rate or medications administered during transport to coordinate your continuing care.

2. For Payment We may use and disclose medical information about you so that the treatment and services you receive may be billed to and payment may be collected from you, an insurance company, or a third party. For example, we may need to give your health plan information about the ambulance transport you received so your health plan will pay us or reimburse you for the service.

3. For Health Care Operations We may use and disclose medical information about you for Daystar EMS Inc. operations. These uses and disclosures are necessary to run the company and make sure that all of our patients receive quality care. For example, we may use medical information to review our treatment and services and to evaluate the performance of our staff in the field.

4. Business Associates We may share your PHI with third-party "business associates" that perform various activities (e.g., billing, transcription services) for the company. Whenever an arrangement between our office and a business associate involves the use or disclosure of your PHI, we will have a written contract that contains terms that will protect the privacy of your PHI.

III. Special Situations Permitted by Law

We may use or disclose your PHI without your permission in the following circumstances:

• As Required By Law: We will disclose medical information about you when required to do so by federal, state, or local law.
• Public Health Risks: We may disclose medical information about you for public health activities, such as preventing or controlling disease, injury, or disability, or reporting reactions to medications.
• Health Oversight Activities: We may disclose medical information to a health oversight agency for activities authorized by law, such as audits, investigations, inspections, and licensure.
• Lawsuits and Disputes: If you are involved in a lawsuit or a dispute, we may disclose medical information about you in response to a court or administrative order.
• Law Enforcement: We may release medical information if asked to do so by a law enforcement official in response to a warrant, summons, or similar process.
• Coroners, Medical Examiners, and Funeral Directors: We may release medical information to a coroner or medical examiner to identify a deceased person or determine the cause of death.
• Organ and Tissue Donation: If you are an organ donor, we may release medical information to organizations that handle organ procurement.

IV. Your Rights Regarding Your PHI

You have the following rights regarding the medical information we maintain about you:

• Right to Inspect and Copy: You have the right to inspect and copy medical information that may be used to make decisions about your care. This usually includes medical and billing records. You must submit your request in writing.
• Right to Amend: If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for Daystar EMS Inc.
• Right to an Accounting of Disclosures: You have the right to request an "accounting of disclosures." This is a list of the disclosures we made of medical information about you for purposes other than treatment, payment, and healthcare operations.
• Right to Request Restrictions: You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment, or health care operations. We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment.
• Right to Request Confidential Communications: You have the right to request that we communicate with you about medical matters in a certain way or at a certain location (e.g., only at work or by mail to a P.O. Box).
• Right to a Paper Copy of This Notice: You have the right to a paper copy of this notice at any time.

V. Changes to This Notice

We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for medical information we already have about you as well as any information we receive in the future. We will post a copy of the current notice in our office and on our website.

VI. Complaints

If you believe your privacy rights have been violated, you may file a complaint with Daystar EMS Inc. or with the Secretary of the Department of Health and Human Services. All complaints must be submitted in writing. You will not be penalized for filing a complaint.

VII. Contact Information

To exercise your rights or if you have questions about this notice, please contact our Privacy Officer:

878A South Dill St, East Bernard, TX 77435

Phone: 346-280-5808