We have created this privacy statement in order to
demonstrate our firm and continuing commitment to the privacy
of personal information provided by those visiting and
interacting with our office and this web site. We hold the
privacy of your personal information in the highest regard.
We recognize the importance of protecting your privacy and
our policy is designed to assist you in understanding how we
collect, use and safeguard the personal information you provide
to us and to assist you in making informed decisions when using
our site. This policy will be continuously assessed against new
technologies, business practices and our customers' needs.
THIS NOTICE DESCRIBES HOW TYLER FAMILY PRACTICE MAY USE AND
DISCLOSE YOUR HEALTHCARE INFORMATION AND HOW YOU CAN OBTAIN
ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Tyler Family Practice is required by law to maintain the
privacy of your protected health information. This information
consists of all records related to your health, including
demographic information, either created by Tyler Family
Practice or received by Tyler Family Practice from other
We are required to provide you with notice of our legal duties
and privacy practices with respect to your protected health
information. These legal duties and privacy practices are
described in this Notice. Tyler Family Practice will abide by
the terms of this Notice, or the Notice currently in effect at
the time of the use or disclosure of your protected health
information. This Notice is prepared in accordance with
the Health Insurance Portability and Accountability Act, 45
Tyler Family Practice reserves the right to change the terms
of this Notice and to make any new provisions effective for all
protected health information that we maintain. Patients will be
provided a copy of any revised Notices upon request. An
individual may obtain a copy of the current Notice from our
office at any time.
Uses and Disclosures of
Your Protected Health Information not Requiring Your
Tyler Family Practice may use and disclose your protected
health information, without your written consent or
authorization, for certain treatment, payment and healthcare
operations. There are certain restrictions on uses and
disclosures of treatment records, which include registration
and all other records concerning individuals who are receiving,
or who at any time have received services for mental illness,
developmental disabilities, alcoholism, or drug dependence.
There are also restrictions on disclosing HIV test results.
Treatment may include:
· Providing, coordinating, or managing healthcare and
related services by one or more healthcare providers;
· Consultations between healthcare providers
concerning a patient;
· Referrals to other providers for treatment;
· Referrals to nursing homes, foster care homes, or
home health agencies.
For example, Tyler Family Practice may determine that you
require the services of a specialist. In referring
you to another doctor, Tyler Family Practice may share or
transfer your healthcare information to that doctor.
Payment activities may include:
· Activities undertaken by Tyler Family Practice to
obtain reimbursement for services provided to you;
· Determining your eligibility for benefits or health
· Managing claims and contacting your insurance
company regarding payment;
· Collection efforts to obtain payment for services
provided to you;
· Reviewing healthcare services and discussing with
your insurance company the medical necessity of certain
services or procedures, coverage under your health plan,
appropriateness of care, or justification of charges;
· Obtaining precertification and preauthorization
of services to be provided to you.
For example, Tyler Family Practice will submit claims to
your insurance company on your behalf. This claim
identifies you, your diagnosis, and the services provided
Healthcare operations may include:
· Contacting healthcare providers and patients with
information about treatment alternatives;
· Conducting quality assessment and improvement
· Conducting outcomes evaluation and development of
· Protocol development, case management, or care
· Conducting or arranging for medical review, legal
services, and auditing functions.
For example, Tyler Family Practice may use your diagnosis,
treatment, and outcome information to measure the quality
of the services that we provide, or assess the
effectiveness of your treatment when compared to patients
in similar situations.
Tyler Family Practice may contact you, by telephone or mail, to
provide appointment reminders. You must notify us if you
do not wish to receive appointment reminders.
We may not disclose your protected health information to
family members or friends who may be involved with your
treatment or care without your written permission. Health
information may be released without written permission to a
parent, guardian, or legal custodian of a child; the guardian
of an incompetent adult; the healthcare agent designated in an
incapacitated patient's healthcare power of attorney; or the
personal representative or spouse of a deceased patient.
There are additional situations when Tyler Family Practice
is permitted or required to use or disclose your protected
health information without your consent or authorization.
Examples include the following:
· As permitted or required by
In certain circumstances we may be
required to report individual health information to legal
authorities, such as law enforcement officials, court
officials, or government agencies. For example, we
may have to report abuse, neglect, domestic violence or
certain physical injuries. We are required to report
gunshot wounds or any other wound to law enforcement
officials if there is reasonable cause to believe that the
wound occurred as a result of a crime.
Mental health records may be disclosed to law enforcement
authorities for the purpose of reporting an apparent crime
on our premises.
· For public health
We may release healthcare records,
with the exception of treatment records, to certain
government agencies or public health authority authorized
by law, upon receipt of written request from that agency.
We are required to report positive HIV test results to the
state epidemiologist. We may also disclose HIV test results
to other providers or persons when there has been or will
be risk of exposure.
We may report to the state epidemiologist the name of any
person known to have been significantly exposed to a
patient who tests positive for HIV. We are required by law
to report suspected child abuse and neglect and suspected
abuse of an unborn child, but cannot disclose HIV test
results in connection with the reporting or prosecution of
alleged abuse or neglect. We may release healthcare
records, including treatment records and HIV test results,
to the Food and Drug Administration when required by
federal law. We may disclose healthcare records, except for
HIV test results, for the purpose of reporting elder abuse
or neglect, provided the subject of the abuse or neglect
agrees, or if necessary to prevent serious harm. Records
may be released for the reporting of domestic violence if
necessary to protect the patient or community from imminent
and substantial danger.
· For health oversight
We may disclose healthcare records, including treatment
records, in response to a written request by any federal or
state governmental agency to perform legally authorized
functions, such as management audits, financial audits,
program monitoring and evaluation, and facility or
individual licensure or certification. HIV test results may
not be released to federal or state governmental agencies,
without written permission, except to the state
epidemiologist for surveillance, investigation, or to
control communicable diseases.
· Judicial and Administrative
Patient healthcare records,
including treatment records and HIV test results, may be
disclosed pursuant to a lawful court order. A
subpoena signed by a judge is sufficient to permit
disclosure of all healthcare records except for HIV test
· For activities related to
We may disclose patient healthcare
records, except for treatment records, to a coroner or
medical examiner for the purpose of completing a medical
certificate or investigating a death. HIV test results may
be disclosed under certain circumstances.
· For research.
certain circumstances, and only after a special approval
process, we may use and disclose your health information to
help conduct research.
· To avoid a serious threat to health
We may report a patient's name and other relevant data to
the Department of Transportation, if it is believed the
patient's vision or physical or mental condition affects
the patient's ability to exercise reasonable or ordinary
control over a motor vehicle. Healthcare information,
including treatment records and HIV test results, may be
disclosed where disclosure is necessary to protect the
patient or community from imminent and substantial
· For workers'
We may disclose your health information to the extent such
records are reasonably related to any injury for which
workers compensation is claimed.
Tyler Family Practice will not make any other use or
disclosure of your protected health information without
your written authorization. You may revoke such
authorization at any time, except to the extent that Tyler
Family Practice has taken action in reliance thereon. Any
revocation must be in writing.
Your Rights Regarding Your Protected Health
You are permitted to request that restrictions be placed on
certain uses or disclosures of your protected health
information by Tyler Family Practice to carry out treatment,
payment, or healthcare operations. You must request such
a restriction in writing. We are not required to agree to
your request, but if we do agree, we must adhere to the
restriction, except when your protected health information is
needed in an emergency treatment situation. In this event,
information may be disclosed only to healthcare providers
treating you. Also, a restriction would not apply when we are
required by law to disclose certain healthcare information.
You have the right to review and/or obtain a copy of your
healthcare records, with the exception of psychotherapy notes,
or information compiled for use (or in anticipation for use) in
a civil, criminal, or administrative action or proceeding.
Tyler Family Practice may deny an access under other
circumstances, in which case you have the right to have such a
denial reviewed. We may charge a reasonable fee for copying
You may request that Tyler Family Practice send protected
health information, including billing information, to you by
alternative means or to alternative locations. You may also
request that Tyler Family Practice not send information to a
particular address or location or contact you at a specific
location, perhaps your place of employment. This request must
be submitted in writing. We will accommodate reasonable
requests by you.
You have the right to request that Tyler Family Practice
amend portions of your healthcare records, as long as such
information is maintained by us. You must submit this request
in writing, and under certain circumstances the request may be
You may request to receive an accounting of the disclosures
of your protected health information made by Tyler Family
Practice for the six years prior to the date of the request,
beginning with disclosures made after April 14, 2003. We
are not required, however, to record disclosures we make
pursuant to a signed consent or authorization.
You may request and receive a paper copy of this Notice, if
you had previously received or agreed to receive the Notice
Any person or patient may file a complaint with Tyler Family
Practice and/or the Secretary of Health and Human Services if
they believe their privacy rights have been violated. To file a
complaint with Tyler Family Practice, please contact the
Privacy Officer at the following:
Michael E Tyler, MD
Tyler Family Practice
14615 San Pedro Ste
San Antonio, TX 78232
It is the policy of Tyler Family Practice that no retaliatory
action will be made against any individual who submits or
conveys a complaint of suspected or actual noncompliance or
violation of the privacy standards.
Tyler Family Practice
Notice of Privacy Practices
Last Updated: October 20,