T & R Clinic, P.A. 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.
UNDERSTANDING YOUR HEALTH INFORMATION
Each time you visit a hospital, physician, or other healthcare provider, a record of your visit is made to manage the care you receive. T & R Clinic, P.A. understands
that the medical information that is recorded about you and your health is personal. The confidentiality of your health information is also protected under both state and
federal law. This Notice of Privacy Practices describes how T & R Clinic, P.A. may use and disclose your information and the rights that you have regarding your
health information.
T & R Clinic, P.A. will not use or disclose your health information without written authorization, except as described in this Notice. Use or disclosure pursuant to this
notice may include electronic transfer of your health information.
YOUR HEALTH INFORMATION RIGHTS
Although your health information is the physical property of the facility or practitioner that compiled it, the information belongs to you, and you have certain rights over
that information.
You have the right to:
Request, in writing, a restriction on certain uses and disclosures of your health information. However, agreement with the request is not required by law, such as when
it is determined that compliance with the restriction cannot be guaranteed. In addition, you have the right to request, in writing, a restriction on disclosures of health
information to a health plan with respect to treatment services for which you have paid out of pocket in full. In this case, we will honor the request. It will be your
responsibility to notify any other provider of this restriction.
-Request by written authorization to inspect or obtain a copy of your health record as provided by law.
-Request, in writing, that your health record be amended as provided by law, if you feel the health information on file is incorrect or incomplete. You will be notified if
the request cannot be granted.
Request that we communicate with you about your health information in a specific way or at a specific location. Reasonable requests will be accommodated.
-Request in writing to obtain an accounting of disclosures or a report of who has accessed your health information as provided by law. The access report will only be
available after federal regulations become effective.
-Obtain a paper copy of this Notice of Privacy Practices on request. You may exercise these rights by directing a request to the Privacy Officer contact listed on this
notice.
You may exercise these rights by directing a request to the Privacy Officer contact listed on this notice
OUR RESPONSIBILITIES
T & R Clinic, P.A. has certain responsibilities regarding your health information, including the requirement to:
-Maintain the privacy of your health information.
-Provide you with this notice that describes T & R Clinic, P.A.’s legal duties and privacy practices regarding the information that we maintain on you.
-Abide by the terms of the notice currently in effect
-Inform you T & R Clinic, P.A. must keep your medical records for a period required by law and then may dispose of them as required by law.
T & R Clinic, P.A. reserves the right to change these privacy policies and practices and to make the changes applicable to any health information that we maintain, if
changes are made, the revised Notice of Privacy Practices will be made available at T & R ClinicP.A. and can be supplied when requested.
USE AND DISCLOSURE OF HEALTH INFORMATION WITHOUT WRITTEN AUTHORIZATION
When you obtain service from T & R Clinic, P.A., certain uses, and disclosures of your health information are necessary and permitted by law to treat you, to process
payments for your treatment, and to support the operation of the entity and other involved providers. The following categories describe ways T & R Clinic, P.A. uses
and discloses your information. All the ways your health information is used or disclosed should fall in one the categories below. We have provided some examples
below.
HEALTH INFORMATION USED FOR TREATMENT
For Example: Disclosure of medical information about you may be made to doctors, nurses, technicians, medical residents, and others who are involved in taking care
of you at T & R Clinic, P.A. This information may be disclosed to other physicians who are treating you or to other health care facilities involved in your care.
Information may be shared with pharmacies, laboratories, radiology center or other health care entities for coordination of care.
HEALTH INFORMATION USED FOR PAYMENT
For Example: Health information about you may be disclosed so services provided to you may be billed to an insurance company or a third party. Information may be
provided to your health plan about treatment you may receive in order to obtain prior approval or to determine if your health plan will cover treatment.
HEALTH INFORMATION USED FOR HEALTH CARE OPERATIONS
For Example: The information in your health record may be used to evaluate and improve the quality of the care and service T & R Clinic, P.A. provides. Students,
volunteers, and trainees may have access to your health information for training and treatment purposes as they participate in the continuing education, training,
internships, and residency programs.
BUSINESS ASSOCIATES
There are some service that T & R Clinic, P.A. provides through contract with a third-party business associate. Examples include but are not limited to transcription
agencies and copying services. To protect your health information T & R Clinic, P.A. requires these business associate to appropriately protect your health information.
CONTINUITY OF CARE
To provide for the continuity of care, your information may be shared with other health care providers such as home health agencies. Information about you may be
disclosed to community services agencies on order to obtain services on your behalf.
DISCLOSURES REQUIRING VERBAL AGREEMENT
Unless you give notice of an objection, and in accordance with your agreement, medical information may be released to a family member or other person who is
involved in your medical care or who helps pay for your care. Information about you may be disclosed to notify a family member, legally authorized representative, or
other person responsible for your care about your location and general condition. This may include disclosures of information about you to an organization assisting in
disaster relief efforts, such as the American Red Cross, so that your family may be notified about you condition. You may object except as due to your incapacity or in
emergency circumstances.
DISCLOSURE REQUIRED BY LAW OR OTHERWISE ALLOWED WITHOUT AUTHORIZATION OR NOTIFICATION
The following disclosures of health information may be made according to state and federal law without your written authorization or verbal agreement.
-When a disclosure is required by federal, state, or local law, judicial or administrative proceedings, or for law enforcement. For example, reporting a gun shot wound,
child abuse, or responding to court orders.
-For public health purposes, such as reporting information about births, deaths, and various diseases, or disclosures to the FDA regarding adverse events related to food,
medications, or devices.
-For health oversight, such as audits, inspections, or licensure investigations.
To organ procurement organizations for the purpose of tissue donation and transplant.
-For research purposes, when the research has been approved by an institution review board that has reviewed the research proposal and established guidelines to
provide for the privacy of your health information; or the disclosure is that of a limited data set, where personal identifiers have been removed.
-To coroners and funeral directors for the purpose of identification, the determination of the cause of death, or perform their duties as authorized by law.
-To avoid a serious threat to the health or safety of a person or the public.
-For workers compensation purposes.
-To military command authorities as required for members of the armed forces.
-To authorized federal officials for national security and intelligence activities as authorized by law.
-To correctional institutions or law enforcement officials concerning the health information of inmates as authorized by law.
OTHER ALLOWABLE USES AND DISCLOSURES WITHOUT AUTHORIZATION
Other uses or disclosures of your health information that may be made include:
-Contacting you to provide appointment reminders for treatment or medical care, as well as to recommend treatment alternatives.
-Notifying you of health-related benefits and services that may be of interest to you.
-Contacting you about disease management programs, wellness programs, or other community-based initiatives or activities in which T & R Clinic, P.A. participates.
BREACH NOTIFICATION
In certain instances, you have the right to be notified in the event that we, or one of out business associates, discover an inappropriate use or disclosure of your health
information. Notice of any such use or disclosure will be made as required by state and federal law.
REQUIRED USES AND DISCLOSURES
Under the law we must make disclosures when required by the Secretary of the Department of Health and Human Services to investigate or determine compliance with
federal privacy law.
USES AND DISCLOSURES REQUIRING AUTHORIZATION
Any other uses or disclosures of your health information not addressed in this notice or otherwise required by law will be made only with your written authorization.
You may revoke such authorization at any time. Specific examples of uses and disclosures requiring authorization include, use of psychotherapy notes, marketing
activities, and some types of sale of your health information.
PRIVACY COMPLAINTS
You have the right to file a complaint if you believe your privacy rights have been violated. This complaint may be addressed to the Privacy Officer contact listed in this
notice, or to the Secretary of the Department of Health and Human Services. There will be no retaliation for registering a complaint.
PRIVACY OFFICER CONTACT
T & R Clinic, P.A.
817-831-0321
PRIVACY AND CONFIDENTIALITY POLICY
Trclinic.com is designed to comply with existing and proposed federal standards for the privacy and confidentiality of health care information. The database and
software components are structured to provide maintenance and routine troubleshooting with no access to your personal information. A security system helps protect
against unauthorized access or misuse by authorized users.
ACCESS AND DISCLOSURE
Trclinic.com does not disclose or provide access to any personal information to anyone without your permission, unless ordered to do so by a court of law or otherwise
required by law. There may be isolated instances in which the staff or outside vendors must access the database to repair problems.
LINKS TO THIRD PARTY SITES
The trclinic.com internet site may contain links to other internet sites (“Linked Sites”). Links are strictly for informational purposes, and the appropriateness of such
links is based on the judgment of the T & R Clinic, P.A. The linked sites are most likely not under the control of T & R Clinic, P.A., and T & R Clinic, P.A.is not
responsible for the content of any linked site that it does not control, including without limitation any link contained in a Linked Site, or any changes or updates to a
linked site. T & R Clinic, P.A.is not responsible for webcasting, or any other form of transmission received from any linked site. T & R Clinic, P.A. provides these links
as a convenience, and the inclusion of any link does not imply endorsement of the site by T & R Clinic, P.A., or any association with its operators. Linked sites will
open in a new browser window, clearly indicating to users that they are leaving the trclinic.com internet site. T & R Clinic, P.A. annually re-evaluates all external
health related websites to which it links. Passive Tracking Mechanisms. T & R Clinic, P.A. is firmly committed to protecting the privacy of website visitors. T & R
Clinic, P.A. uses web logs and temporary internet cookies to gather aggregate, not individual data, about site visitors. The following information is contained in these
web logs:
-The date and time of the visit as well as length of stay.
-The pages of trclinic.com viewed during the visit.
-The IP address of the computer used to visit the site.
-The type of web browser and operating system used to view the site.
-The internet domain from which a visitor accessed the site.
Cookies are packets of information that a website transfers to a user’s computer for record-keeping purposes. They are a means of keeping track of a user’s preferences
during a visit to a web site. Some services on our website use multi-session cookies, also known as “persistent cookies.” Persistent cookies are:
-Small bits of text temporarily stored in your computer.
-Placed on your computer for more than a single session.
-Used to differentiate between new and returning site visitors, to customize our website for frequent visitors, and to assess site design and content. Persistent cookies
placed on your computer will expire two years after your last visit to our website.
If you do not want information to be collected via cookies, you can turn off cookies in your browser. To turn off cookies in Microsoft Internet Explorer, choose Tools
from the top navigation, select Internet Options, choose privacy, and change the settings for trclinic.com. We collect and store no other information about you when you
visit our site unless you choose to provide it. For example: If you send us an email or submit an online form, we will receive only the personal information you include
in the form.
SPYWARE
trclinic.com does not deploy spyware or any software that aids in gathering information about a person or organization without their knowledge.
T & R Clinic, P.A., 2919 Markum Dr., Fort Worth, TX 76117, (817)831-0321