Office Policies

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Our Mission

Our mission is to provide total patient care for the entire family, with an emphasis on preventive medicine. WHEN FAMILIES TALK, WE LISTEN!

Office Hours

We are open to serve you, answer questions, or schedule an appointment during the following hours:

Monday – Thursday: 8a.m.–5p.m.
Friday: 8a.m.–12p.m.

Should you have an emergency during non-office hours, call Hill Country Memorial at 830/997-4353 and they will connect you with the doctor on call for our office.  We ask that you not call your doctor or staff directly as they may be off call.


Appointments

Appointments are scheduled from 8-4:30 M-Th & 8-11:30 on Friday.  Emergencies will be worked in as appropriate throughout the day.  If it is necessary to cancel, a 24 hour notice is required. The 2nd time you miss an appointment without calling, you will be charged $25. The 3rd time you miss an appointment without calling, you will be dismissed as a patient from our practice.  Same day cancellations will be considered a missed appointment.  If you are more than 15 minutes late for an appointment without calling, you may be asked to reschedule.

Fees

Payment is due at the time of service.  For those patients with managed care plans, your insurance contract requires you to pay your co-pay at the time of service and we will file the remaining balance to your insurance company.  Request for Mid-Texas Health Care to send an invoice for co-pays not paid at the time of service, will result in a $10 Processing Fee added to the invoice.  If you have not met your deductible, you will be expected to pay up to the remainder of your deductible along with any co-insurance, at the time of service.  All previous balances are to be paid in full or a payment plan made, prior to additional services being rendered. If payment cannot be made, arrangements must be made in advance. All charges are due and payable within 10 days of receipt of your statement.  You are directly responsible to us for any unpaid balance on your account.  MasterCard, VISA, American Express and Discover credit cards are accepted. Patients with a past due balance and no payment received on account after 3 consecutive statements, will be dismissed from our practice and the past due balance will be forwarded to a collection agency who reports to the credit bureaus.  We also offer our patients a "Prompt Pay Discount". Patients who pay IN FULL, at the time of service, will receive a 20% discount (this discount does not apply to lab work, vaccines, and supplies).  

​Lab and X-Ray

Abnormal results will be called to the patient or an appointment may be scheduled to discuss the results with your doctor. Copies of these results will be provided upon request.  You may receive a bill from the pathologist, radiologist, or lab for consultations on biopsies, reading of x-rays, or running of lab tests. 


​Medication Refills

For medication refills, please contact your pharmacy FIRST.  The pharmacy will fax or phone us for the refill. Other than emergencies, please allow 3 days for refill of routine medications.  Pain medications and controlled substances, can only be refilled during regular office hours.  Please check with your pharmacy to see if your prescription is ready.  We will only call you if we have questions. Renewal of your medications ​is​ contingent upon annual physical exams and appropriate blood work.

​Insurance

We accept assignment from Medicare & Medicaid, as well as commercial carriers we are contracted with, and file all claims for these plans.  We require payment in full at the time of service from patients with insurance plans we are not contracted with, however we will file the claim for you as a courtesy.  If you need assistance or have questions regarding filing of claims, please contact our office.  If your insurance company requires a specific form with the doctor's signature, please complete the patient portion in full before bringing it to our office.  Our doctors will not sign an incomplete form.  Disability forms and complicated insurance forms may require an office visit.

 

Notice of Privacy Practices

 Effective Date:1/1/2015

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.

If you have any questions about this Notice, please contact:

Kristie Anderson at 830/997-7626 x5

Who Will Follow This Notice?

ü  Mid-Texas Health Care

ü  Dr. David Cantu and Dr. Yvonne Haug

ü  All employees

We understand that medical information about you and your health is personal and are committed to protecting this information.  When you receive care at Mid-Texas Health Care, a record of the care and services you receive is made.  Typically, this record contains your treatment plan, history and physical, test results, and billing record.  This record serves as a:

·         Basis for planning your treatment and services;

·         Means of communication among the physicians and other health care providers  involved in your care;

·         Means by which you or a third-party payor can verify that services billed were actually provided;

·         Source of information for public health officials; and

·         Tool for assessing and continually working to improve the care rendered.

This Notice tells you the ways we may use and disclose your Protected Health Information (referred to herein as “medical information”).  It also describes your rights and our obligations regarding the use and disclosure of medical information.

Our Responsibilities.

Mid-Texas Health Care shall:

§  Make every effort to maintain the privacy of your medical information;

§  Provide you with notice of our legal duties and privacy practices with respect to information we collect and maintain about you;

§  Abide by the terms of this notice;

§  Notify you if we are unable to agree to a requested restriction; and

§  Accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations.

§  Mid-Texas Health Care will notify you, and the Department of Health & Human Services, of any unauthorized acquisition, access, use or disclosure of your unsecured medical information that presents a significant risk of financial, reputational or other harm to you, to the extent required by law.  Unsecured medical information means medical information not secured by technology that renders the information unusable, unreadable, or indecipherable as required by law.

Methods in Which We May Use and Disclose Medical Information about You.

The following categories describe different ways we may use and disclose your medical information.  The examples provided serve only as guidance and do not include every possible use or disclosure.

Ø  For TreatmentWe will use and disclose your medical information to provide, coordinate, or manage your health care and any related service.  For example, we may share your information with your primary care physician or other specialists to whom you are referred for follow-up care.

Ø  For Payment.  We will use and disclose medical information about you so that the treatment and services you receive may be billed and payment may be collected from you, an insurance company, or a third party. For example, we may need to disclose your medical information to a health plan in order for the health plan to pay for the services rendered to you. 

Ø  For Health Care Operations.  We may use and disclose medical information about you for office operations. These uses and disclosures are necessary to run Mid-Texas Health Care in an efficient manner and provide that all patients receive quality care. For example, your medical records and health information may be used in the evaluation of services, and the appropriateness and quality of health care treatment. In addition, medical records are audited for timely documentation and correct billing.

Ø  Appointment Reminders.  We may use and disclose medical information in order to remind you of an appointment. For example,  Mid-Texas Health Care may provide a written or telephone reminder that your next appointment with Mid-Texas Health Care is coming up.

Ø  ResearchUnder certain circumstances, we may use and disclose medical information about you for research purposes. For example, a research project may involve comparing the surgical outcome of all patients for whom one type of procedure is used to those for whom another procedure is used for the same condition. All research projects, however, are subject to a special approval process. Prior to using or disclosing any medical information, the project must be approved through this research approval process. We will ask for your specific authorization if the researcher will have access to your name, address, or other information that reveals who you are, or will be involved in your care.

Ø  As Required by LawWe will disclose medical information about you when required to do so by federal or Texas laws or regulations.

Ø  To Avert a Serious Threat to Health or SafetyWe may use and disclose medical information about you to medical or law enforcement personnel when necessary to prevent a serious threat to your health and safety or the health and safety of another person.

Ø  Sale of Practice.  We may use and disclose medical information about you to another health care facility or group of physicians in the sale, transfer, merger, or consolidation of our practice.

 Special Situations.

Ø  Organ and Tissue Donation.  If you have formally indicated your desire to be an organ donor, we may release medical information to organizations that handle procurement of organ, eye, or tissue transplantations.

Ø  Military and Veterans.  If you are a member of the armed forces, we may release medical information about you as required by military command authorities.

Ø  Workers’ CompensationWe may release medical information about you for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illness.

Ø  Qualified PersonnelWe may disclose medical information for management audit, financial audit, or program evaluation, but the personnel may not directly or indirectly identify you in any report of the audit or evaluation, or otherwise disclose your identity in any manner.

Ø  Public Health RisksWe may disclose medical information about you for public health activities. These activities generally include the following activities:

·         To prevent or control disease, injury, or disability;

·         To report reactions to medications or problems with products;

·         To notify people of recalls of products they may be using;

·         To notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition; and

·         To notify the appropriate government authority if we believe you have been the victim of abuse, neglect, or domestic violence.

All such disclosures will be made in accordance with the requirements of Texas and federal laws and regulations.

Ø  Health Oversight Activities.  We may disclose medical information to a health oversight agency for activities authorized by law. Health oversight agencies include public and private agencies authorized by law to oversee the health care system. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, eligibility or compliance, and to enforce health-related civil rights and criminal laws.

Ø  Lawsuits and Disputes.  If you are involved in certain lawsuits or administrative disputes, we may disclose medical information about you in response to a court or administrative order.

Ø  Law Enforcement.  We may release medical information if asked to do so by a law enforcement official:

·         In response to a court order or subpoena; or

·         If Mid-Texas Health Care determines there is a probability of imminent physical injury to you or another person, or immediate mental or emotional injury to you.

Ø  Coroners, Medical Examiners and Funeral Directors.  We may release medical information to a coroner or medical examiner when authorized by law (e.g., to identify a deceased person or determine the cause of death). We may also release medical information about patients to funeral directors.

Ø  Inmates.  If you are an inmate of a correctional facility, we may release medical information about you to the correctional facility for the facility to provide you treatment.

Ø  Other Uses or Disclosures.  Any other use or disclosure of PHI will be made only upon your individual written authorization.  You may revoke an authorization at any time provided that it is in writing and we have not already relied on the authorization.

Your Rights Regarding Medical Information about You.

You have the following rights regarding medical information collected and maintained about you:

Ø  Right to Inspect and Copy.  You have the right to inspect and copy medical information that may be used to make decisions about your care.  Usually, this includes medical and billing records. To inspect and copy medical information that may be used to make decisions about you, you must submit your request in writing to the Privacy Officer for Mid-Texas Health Care.  If you request a copy of the information, Mid-Texas Health Care may charge a fee established by the Texas Medical Board for the costs of copying, mailing, or summarizing your records. Mid-Texas Health Care may deny your request to inspect and copy in certain very limited circumstances.  If you are denied access to medical information, you may request that the denial be reviewed.  Another licensed health care professional chosen by Mid-Texas Health Care will review your request and denial. The person conducting the review will not be the person who denied your request.  Mid-Texas Health Care will comply with the outcome of the review.

Ø  Right to Amend.  If you feel that medical information maintained about you is incorrect or incomplete, you may ask Mid-Texas Health Care to amend the information. You have the right to request an amendment for as long as the information is kept by Mid-Texas Health Care. To request an amendment, your request must be made in writing and submitted to Mid-Texas Health Care.  In addition, you must provide a reason that supports your request.

Mid-Texas Health Care may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, Mid-Texas Health Care may deny your request if you ask us to amend information that:

·         Was not created by Mid-Texas Health Care, unless the person or entity that created the information is no longer available to make the amendment;

·         Is not part of the medical information kept by Mid-Texas Health Care;

·         Is not part of the information which you would be permitted to inspect and copy; or

·         Is accurate and complete.

Ø  Right to an Accounting of Disclosures.  You have the right to request an “accounting of disclosures.” This is a list of the disclosures made of your medical information for purposes other than treatment, payment, or health care operations. To request this list you must submit your request in writing to Mid-Texas Health Care. Your request must state a time period, which may not be longer than six (6) years. Your request should indicate in what form you want the list (for example, on paper or electronically). The first list you request within a 12-month period will be free. For additional lists within the 12-month period, you may be charged for the cost of providing the list. Mid-Texas Health Care will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.

Ø  Right to Request Restrictions.  You have the right to request a restriction or limitation on the medical information Mid-Texas Health Care uses or discloses about you for treatment, payment or health care operations. You also have the right to request a limit on the medical information Mid-Texas Health Care discloses about you to someone who is involved in your care or the payment for your care. Mid-Texas Health Care is not required to agree to your request, unless the request pertains solely to a healthcare item or service for which Mid-Texas Health Care has been paid out of pocket in full. Should Mid-Texas Health Care agree to your request, Mid-Texas Health Care will comply with your request unless the information is needed to provide you emergency treatment. To request restrictions you must make your request in writing to Mid-Texas Health Care.  In your request, you may indicate: (1) what information you want to limit; (2) whether you want to limit Mid-Texas Health Care’s use and/or disclosure; and (3) to whom you want the limits to apply.

Ø  Right to Request Confidential Communications. You have the right to request that Mid-Texas Health Care communicate with you about medical matters in a certain way or at a certain location.  For example, you can ask that Mid-Texas Health Care contact you only at work or by mail. To request that Mid-Texas Health Care communicate in a certain manner, you must make your request in writing to the Privacy Officer.  You do not have to state a reason for your request.  Mid-Texas Health Care will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.

Changes to This Notice.

We reserve the right to change our practices and to make the new provisions effective for all PHI we maintain. Should our information practices change, we will post the amended Notice of Privacy Practices in our office.  You may request that a copy be provided to you by contacting the Privacy Officer .

Complaints.

If you believe your privacy rights have been violated, you may file a complaint with Mid-Texas Health Care or with the Office for Civil Rights, U.S. Department of Health and Human Services. To file a complaint with Mid-Texas Health Care, contact the Privacy Officer at 830/997-7626 x5.  Your complaint must be filed within 180 days of when you knew or should have known that the act occurred.  The address for the Office of Civil Rights is:

Secretary of Health & Human Services
Region VI, Office for Civil Rights

U.S. Department of Health and Human Services

1301 Young Street, Suite 1169

Dallas, TX 75202

All complaints should be submitted in writing.

You will NOT be penalized for filing a complaint.

​Non-Discrimination

Mid-Texas Health Care (MTHC) complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.  Mid-Texas Health Care does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

 

-MTHC provides free aids and services to people with disabilities to communicate effectively with us, such as:

○ Qualified sign language interpreters

○ Written information in other formats (large print, audio, accessible electronic formats, other formats)

 

-MTHC provides free language services to people whose primary language is not English, such as:

○ Qualified interpreters

○ Information written in other languages

 

If you need these services, contact MTHC at 830/997-7626, (Relay Texas/TTY: 800/735-2989).

If you believe that MTHC has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance:

 ○ By mail at:  U.S. Department of Health and Human Services, Office for Civil Rights

    200 Independence Ave S.W., Room 509F HHH Bldg., Washington, D.C.  20201

○ By phone at:  800/368-1019, TDD 800/537-7697

○ By email atOCRComplaint@hhs.gov

○ Online portal at:  https://ocrportal.hhs.gov/ocr/portal/lobby.jsf

○ Complaint forms are available at: http://www.hhs.gov/ocr/office/file/index.html

SPANISH ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 830/997-7626, (Relay Texas/TTY 800/735-2989)

 

VIETNAMESE CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 830/997-7626, (Relay Texas/TTY 800/735-2989)

 

CHINESE  注意:如果您使用繁體中文,您可以免費獲得語言援助服務。請致電 830/997-7626, (Relay Texas/TTY 800/735-2989)

 

KOREAN주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 있습니다. 830/997-7626, (Relay Texas/TTY 800/735-2989) 번으로 전화해 주십시오.

 

ARABIC  ملحوظة: إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغویة تتوافر لك بالمجان. اتصل برقم  830/997-7626 (Relay Texas/TTY 800/735-2989), رقم والبكم الصم 

 

URDU  خبردار: اگر آپ اردو بولتے ہیں، تو آپ کو زبان کی مدد کی خدمات مفت میں دستیاب ہیں ۔ کال  830/997-7626, (Relay Texas/TTY 800/735-2989)

FILIPINO TAGALOG PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 830/997-7626, (Relay Texas/TTY 800/735-2989)

 

FRENCH ATTENTION : Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement. Appelez le 830/997-7626 (Relay Texas/TTY 800/735-2989)

 

HINDI ध्यान : यद आप हदी बोलते   तो आपके िलए मुफ्त भाषा सहायता सेवाएं उपलब्ध ह। 830/997-7626 (Relay Texas/TTY 800/735-2989)  पर कॉल कर।

 

FARSI توجھ: اگر بھ زبان فارسی گفتگو می کنید، تسھیلات زبانی بصورت رایگان برای شما .بگیرید تماس  با. باشد می ف 830/997-7626, (Relay Texas/TTY 800/735-2989) 

 

GERMAN  ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer 830/997-7626, (Relay Texas/TTY 800/735-2989)

 

GUJARATI  ચુ ના: જો તમેજરાતી બોલતા હો, તો િન:લ્કુ ભાષા સહાય સેવાઓ તમારા માટઉપલબ્ધ . ફોન કરો 830/997-7626, (Relay Texas/TTY 800/735-2989)

 

RUSSIAN ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 830/997-7626, (Relay Texas/TTY 800/735-2989)

 

JAPANESE  注意事項:日本語を話される場合、無料の言語支援をご利用いただけます830/997-7626, (Relay Texas/TTY 800/735-2989)  まで、お電話にてご連絡ください。

 

LAOTIAN  ໂປດຊາບ: ຖ້າວ່າ ທ່ານເວົ້າພາສາ ລາວ, ການບໍລິການຊ່ວຍເຫຼືອດ້ານພາສາ, ໂດຍບໍ່ເສັຽຄ່າ, ແມ່ນມີພ້ອມໃຫ້ທ່ານ. ໂທຣ 830/997-7626, (Relay Texas/TTY 800/735-2989)