Notice of Privacy Practices

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.

This Notice of Privacy Practices applies to Norwalk Area Health Systems operating as a clinically integrated health care arrangement composed of : Fisher –Titus Medical Center: Fisher-Titus Memorial Hospital and Norwalk Memorial Home; Norwalk Area Health Services d.b.a. North Central EMS, The Carriage House of Fisher-Titus Medical Center; Fisher-Titus Medical Center Home Health Services; the employed physician offices of Fisher-Titus Medical Care LLC; and Fisher-Titus Foundation. All entities and persons listed will share personal health information of our patients as necessary to carry out treatment, payment and health care operations as permitted by law.

Each time you receive services from Fisher-Titus Medical Center, we make a record of the information gathered during your visit. This information is used for a number of purposes. These uses are set forth below. You have certain rights regarding this information. Your rights regarding this information are set forth below. Finally, we have certain responsibilities regarding our use of your information. Our responsibilities are set forth below.

USES AND DISCLOSURES OF HEALTH INFORMATION

TREATMENT: We are permitted by law to use your health information to provide treatment to you. For example, we will provide your physician and our other clinicians involved in your care and treatment with the information in our records to assist the physician in providing proper care to you. We will also provide this information to subsequent health care providers. These individuals may create additional information related to the care and treatment they provide you.

PAYMENT: We are permitted by law to use your health information to obtain payment for our services.   For example, we may send your insurance company or other payor a bill that may include your health information. This includes use of your health information by our business associates, such as billing companies, claims processing companies, law firms, collection agencies, and others that process our health care claims. We may also give your information to another health care provider who has treated you for their payment purposes. You may restrict the disclosure of protected health information sent to a health plan for payment or health care operations purposes if the disclosure relates to products or services that were paid for solely out-of-pocket and in full.

We may also tell your health plan about a treatment that you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment.

HEALTH CARE OPERATIONS: We are permitted by law to use your health information to perform our regular health care operations. For example, we may use your health information to assess the quality of care we provide in order to maintain our standards. Other uses may include but are not limited to professional peer review, accrediting, licensing, business management, etc. We may provide information about you to our accountants, attorneys, consultants and others in order to make sure we are complying with laws that affect us. We may also disclose your information to another healthcare facility, health care professional or health plan if they have or had a patient relationship with you.

OTHER WAYS WE ARE LEGALLY PERMITTED TO USE YOUR PROTECTED HEALTH INFORMATION

Appointment Reminder: We may provide appointment reminders to you or to advise you of information regarding your treatment.

We may use your information to contact you for fundraising purposes. You have the right to opt out of receiving such communications.

We are permitted, and in some cases required, by law to make certain other disclosures of health information without your consent. We may disclose your health information, if appropriate, to the following entities under the following circumstances:

  • to public health agencies to satisfy certain reporting requirements, such as births and deaths, certain communicable diseases, child abuse, and other public health issues
  • to health oversight agencies, such as governmental auditors, the Department of Health, and other agencies when required
  • to any individual when ordered by a court or other legal process to do so
  • to law enforcement officials when necessary for law enforcement purposes and permitted or required by law
  • to a coroner or medical examiner when necessary to enable them to perform their duties
  • to organ procurement organizations, to enable them to make suitability determinations
  • in cases of emergency
  • to researchers if their research has been approved by an institutional review board and they take certain steps to protect your privacy
WHEN YOUR AUTHORIZATION IS REQUIRED:

Your authorization is required if your information is released for other uses and disclosures not described in this Notice. This includes uses and disclosures of your information for marketing purposes. Uses and disclosures that involve the sale of your protected health information. Most uses and disclosures of your psychotherapy notes. You have the right to withdraw your authorization at any time.

YOUR INDIVIDUAL RIGHTS

You have certain rights regarding your health information. These rights include:
  • the right to obtain a paper copy of this notice upon request
  • the right to inspect and copy your health information (copies are available for a reasonable fee)
  • the right to request amendments to your health information you believe to be inaccurate
  • the right to obtain an accounting of our uses and disclosures of your health information, subject to certain exceptions
  • the right to request restrictions on our permitted uses and disclosures of your information although we are not legally obligated to honor this request, unless you have paid cash for your health care services and do not want your information sent to your health plan, in which case we are legally required to honor your request
  • the right to request that communications regarding your health information be sent by alternative means or at alternative locations
OUR RESPONSIBILITIES

We are required by law to maintain the privacy of your information in accordance with this notice. We are also required upon your request to provide you with this notice explaining our duties and practices regarding your health information. We are required to abide by the terms of this notice. We are also required to notify you of any breach as a result of which your unsecured protected health information is improperly disclosed, as defined by law.

We reserve the right to change the content of this notice and to make new provisions regarding your protected health information. We will provide you a revised notice upon your request after the revisions are effective.

If you have any questions regarding this notice or wish to exercise any of your rights as described herein, you may contact the Privacy Officer at 419/660-2580. In addition, you can file a complaint with the Privacy Officer of Fisher-Titus Medical Center by contacting her at 419/660-2580, or in writing to her at Privacy Officer, Fisher Titus Medical Center, 272 Benedict Ave., Norwalk, Ohio 44857 Attn. Sharon Harwood. Finally, you can submit a complaint to the Secretary of Health and Human Services. We will not retaliate against you for filing a complaint.