Notice of Electronic Disclosure of Protected Health

Information in accordance with Texas HB 300*

Please be advised that this office maintains our patients’ protected health information (PHI) in electronic form (“Electronic Health Records”). All electronic health records maintained by this office, including your PHI, are subject to electronic disclosure.

This office cares about the privacy of your Protected Health Information (PHI). If we obtain or create information about your health, we are required by law to protect the privacy of your information. PHI may include information that relates to:

• Your past, present, or future physical or mental health or condition;
• Healthcare provided to you; and
• Past, present, or future payment for your healthcare.

Under applicable federal and Texas state law, we are required under certain circumstances to obtain a separate authorization from you for each electronic disclosure of your protected health information. This authorization may be made in written or electronic form or orally if documented in writing by our office.

The authorization for electronic disclosure of protected health information is not required for disclosures related to treatment, payment, healthcare operations, performing certain insurance functions, or as may be otherwise authorized by law. (Tex. Health & Safety Code §§ 181.154(b),(c), § 241.153; 45 C.F.R. §§ 164.502(a)(1); 164.506, and 164.5080).

For a complete list of reasons that this office is allowed by law to share your PHI, please refer to our Notice of Privacy Practices for electronic disclosures of protected health information that do and do not require your authorization.

* This notice is provided pursuant to federal law and Section 181.154 of the Texas Health and Safety Code.