Our practice is dedicated to maintaining the privacy of your protected health information (PHI).  In conducting our business, we will create records regarding you and the treatment we provide to you.  We are required by law to maintain the confidentiality of health information that identifies you.  By Federal and State law, we must follow the terms of the notice of privacy practices that we have in effect at this time.

These laws are complicated, but we must provide you with the following important information:

• How we may use and disclose your PHI
• Your rights regarding PHI about you
• Our obligations concerning the use and disclosure of your PHI

IF YOU HAVE QUESTIONS ABOUT THIS NOTICE PLEASE CONTACT:

CATHY ANDERSON, RN, BSN
TLU HEALTH CENTER
1000 W COURT
SEGUIN, TX 78155
830-372-8068
canderson@tlu.edu

Uses and Disclosures
Treatment.  Your health information may be used by the nurse or doctor for the purpose of evaluating your health, diagnosing medical conditions, and providing treatment.  PHI may be provided to the University Athletic Trainer if you are participating in intercollegiate athletics.  We may use and disclose PHI about you when you need a prescription, lab work, and x-ray or other health care services including referral to another health care provider.

Payment.  You will not be charged for services at the Health Center.  When money paid for immunizations is deposited in the Business Office, your name and the statement “shot” or “immunization” will be used for the purpose of receipt.  The university will not submit claims to your insurance company.

Appointment Reminders and Follow Up Calls.  We will use email, campus mail, your cell phone and room phone to contact you.

Law Enforcement.  Your PHI may be disclosed to law enforcement agencies, without your permission, to support government audits and inspections and to facilitate law enforcement investigations.

Public Health Reporting.  Your PHI may be disclosed to public health agencies as required by law.  For example, we are required to report certain communicable diseases to the Texas Department of State Health Services.

Serious Threats to Health or Safety.  We may disclose your PHI when necessary to reduce or prevent a serious threat to your health and safety as well as that of another individual or the public.

Workers Compensation.  We may release your PHI for worker’s compensation and similar programs.

Other uses and disclosures require your authorization
Disclosures of your PHI or its use for any purpose other than those listed above require your specific written authorization.  If you change your mind after authorizing a use or disclosure of your information, you must submit a written revocation of the authorization.  However, your decision to revoke the authorization will not affect or undo any use or disclosure of information that occurred before you notified us of your decision.

Individual Rights
You have certain rights under the federal privacy standards.  These include:

• The right to request restrictions on the use and disclosure of your PHI
• The right to receive confidential communications concerning your medical condition and treatment.
• The right to inspect and receive a copy of your PHI
• The right to amend or submit corrections to your PHI
• The right to receive an accounting of how and to whom you PHI has been disclosed.
• The right to receive a printed copy of this notice.

Right to Revise Privacy Practices
As permitted by law, we reserve the right to amend or modify our privacy policies and practices as may be required by changes in federal and state laws and regulations.

Requests to Inspect PHI
As permitted by federal regulation, we require that requests to inspect or copy PHI be submitted in writing.  We consider an emailed request to be a request “in writing”.  Contact the nurse at the Health Center regarding such requests.

Complaints
If you would like to submit a comment or complaint about our privacy practices, you can do so by sending a letter outlining your concerns to:

Texas Lutheran University
Health Center
1000 W Court
Seguin, TX 78155

If you believe that your privacy rights have been violated, you should call the matter to our attention by sending a letter describing the cause of your concern to the same address.  You will not be penalized or otherwise retaliated against for filing a complaint. Contact Person:  Cathy Anderson, RN, BSN  830-372-8068.