Life Line Medical Ambulance
Life Line Medical Ambulance
200 Center Street

Fulton, Ohio
419-864-3967

Life Line Medical Ambulance cares about protecting its patients' privacy. In accordance with the Health Insurance Portability & Accountability Act (HIPAA) of 1996, the Bureau is providing you with an explanation of your patient rights, information about the use of certain information collected and the procedures for acquiring your patient trip sheet/transport sheets.
COLLECTING OF INFORMATION
We collect and retain information necessary for us to provide services you have requested or utilized when calling our services. During our interaction with you or a family member, we may collect non-public information from you because of your injury or illness.
SHARING OF INFORMATION
We may share information with  the hospital, legal representatives acting on your behalf or family members regarding your benefits and health coverage in order to comply with legal or regulatory requirements. We will also share information on your behalf for payments of services from your insurance company, etc. We will not share names, social security numbers, etc. to non authorized persons.
INTERNAL PROTECTION OF INFORMATION
We will restrict access to non-public personal information about you to those employees whom have a need to know. Our EMS is in full compliance with HIPAA, which focuses on protecting your personal patient information, however we will review records for Quality Assurance and Quality Improvement, Billing purposes, and legal purposes. We maintain both electronic and physical procedural safeguards to comply with Federal and State regulations with regards to protecting this information.
DISCLOSURE OF OUR PRIVACY POLICY
This notice is being provided to you for informational purposes and may be amended and updated as required. No action is necessary to ensure your privacy and no response is required. Your information will only be disclosed in accordance with HIPAA.
PATIENT RIGHTS & ACCESS
All patients have the right to access their patient health information (PHI). You may request to amend your records and or request a copy of your trip sheet, which must be submitted in writing by the patient or the POA. If you have questions about your trip sheet you should contact the office. There is a charge for access and a processing fee per page. We thank you for your cooperation.


Updated October 20157

For Questions/Concerns please contact Shona Searls EMT-P, RN at lifelinemedicalambulance@gmail.com