The information contained on ASI is neither intended as rendering medical advice nor as a substitute for seeking professional medical assistance. No relationship between ASI and its practitioners may be created through ASI. Any individual with specific questions regarding their individual health or treatment options should contact ASI and schedule an appointment.
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Protecting your privacy
Protecting your privacy and your medical information is at the core of our business. We recognize our obligation to keep your information secure and confidential whether on paper or the Internet. At The ASI (hereinafter referred to as “the Practice”), privacy is one of our highest priorities.
Keeping your information
Keeping the medical and health information we have about you secure is one of our most important responsibilities. We value your trust and will handle your information with care. Our employees access information about you only when necessary to provide treatment, verify eligibility, obtain authorization, process claims and otherwise meet your needs. We may also access information about you when considering a request from you or when exercising our rights under the law or any agreement with you.
We safeguard information during all business practices according to established security standards and procedures, and we continually assess new technology for protecting information. Our employees are trained to understand and comply with these information principles.
Working to meet your needs through information
In the course of doing business, we collect and use various types of information, like name and address and claims information. We use this information to provide service to you, to process your claims and to bring you health information that might be of interest to you.
Keeping information accurate
Keeping your health information accurate and up-to-date is very important. If you believe the health information we have about you is incomplete, inaccurate or not current, please call or write us at the telephone numbers or addresses listed below. We take appropriate action to correct any erroneous information as quickly as possible through a standard set of practices and procedures.
How – and why – information is shared
We limit who receives information and what type of information is shared.
CONSENT AND ACKNOWLEDGMENT OF RECEIPT OF PRIVACY NOTICE FORM INSTRUCTIONS
A physician with a direct patient relationship with an individual is not required to obtain the consent of the patient prior to using protected health information (or disclosing it to third parties) for purposes of carrying out treatment, payment or health care operations. While the modifications to the final Privacy Rule reduced the necessity for a mandatory consent form, it provided for an acknowledgment of receipt of a Notice of Privacy Practices. This consent form accomplishes that purpose. A consent form should be signed during initial paperwork for each new patient and as soon as possible for existing patients.
This form does not require a witness; however, we recommend that the form be witnessed whenever possible as it may help prevent misunderstandings at a future date.
If you wish to complain to the Board, please do so in writing. Provide full name and practice address of practitioner. Also, provide dates and details of any incident, being as specific as possible. The Board will acknowledge receipt of your complaint. If your complaint is within the Board’s jurisdiction, it will be assigned for proper study. Complainants are advised of an investigation status approximately every 90 days until final action is taken.
Mail – Send your complaint in writing to:Texas Medical Board
Investigations Department, MC-263
P.O. Box 2018
Austin, TX 78768-2018
* Policies and Procedures: Permitted Uses and Disclosures without Authorization
* Minimum Necessary Use and Disclosure of Protected Health Information
* Uses and Disclosures of PHI by and for Personal Representatives, Minors and Deceased
* Incidental Uses and Disclosures