Patients & Visitors




If you have any questions about this notice, please contact the Privacy Officer at the phone number listed at the end of this Notice.

The federal Health Insurance Portability and Accountability Act (HIPAA) of 1996 contains provisions that give you greater access to your health information. This includes your medical record, your billing and insurance records, and any other information the hospital might collect to provide healthcare services to you or to receive payment for the healthcare services rendered. HIPAA requires we provide you with this Notice and that we follow its terms and the commitments we make in it.

Unless it is specifically provided for by HIPAA, we may not use or disclose your health information without your written authorization. You may revoke your authorization at any time.

This Notice will tell about the ways in which our facility may use your medical information and disclose your medical information to others outside the facility. The law requires the Facility to:

  • Ensure that medical information that identifies you is kept private;
  • Inform you of our legal duties and privacy practices with respect to your medical information;
  • Follow the terms of the Notice that is currently in effect; and
  • Notify you if your medical information is affected by a breach.

Who Will Follow This Notice: The Facility and all of its sites and locations will follow the terms of the Notice. The following people will also follow the terms of this Notice:

  • All employees, contractors, volunteers, and other agents (“authorized personnel”) of the facility.
  • Health care professionals authorized to enter information onto you medical records at the facility.
  • Members of the Facility’s medical staff and their authorized personnel.
  • Health care providers who share an electronic medical record with the Facility may also use this Notice (although they may have their own, which they will follow).

How the Facility May Use and Disclose Your Medical Information: We may use your medical information or share it with others for the following purposes:

  • Treatment – Your medical information may be used to provide you with medical treatment or services. This medical information may be disclosed to doctors, interns, nurses, technicians, volunteers, students, and others involved in your care at the Facility. We may also share your medical information with health care providers and their staff outside the Facility. We may also use your medical information to contact you to provide appointment reminders or to give you information about treatment options or other health related benefits and services that may interest you.
  • Payment – Your medical information may be used and disclosed so that the treatment and services received at the Facility may be billed and payment may be collected from you, your insurance company and/or a third party. Please note, we will comply with your request not to disclose your health information to your insurance company if the information relates solely to a healthcare item or service for which you have paid out of pocket and in full to us.
  • Healthcare Operations – The facility will use and disclose your health information within our own organization so that the facility runs efficiently and complies with the state and federal laws. For example, your medical information may be reviewed to evaluate the treatment and services performed by our staff in caring for you. We may also disclose your health information to our accreditation and patient satisfaction surveyors to help us evaluate the quality of care we provide.
  • Participation in Health Information Exchanges – We may participate in one or more health information exchanges (HIEs) and may electronically share your health information for treatment, payment and permitted healthcare operation purposes with other participants in the HIE, including entities that may not be listed under “Who Will Follow This Notice” on the first page of this Notice. You may be asked to “opt-in” in order to share your information with HIEs, or you may be provided the opportunity to “opt-out” of HIE participation. HIEs allow your health care providers to efficiently access your medical information that is necessary for treating you and other lawful purposes. We will not share your information with an HIE unless the HIE is subject to HIPAA privacy and security requirement.
  • As required by law – Your medical information will be disclosed when we are required to do so by federal, state, or local authorities, laws, rules and/or regulations.
  • For Health Oversight activities – The Facility may disclose your health information to a health oversight agency for activities authorized by law.
  • Lawsuits and Disputes – The Facility will respond to a valid subpoena or court order for records when such records are necessary to a lawsuit.
  • Law Enforcement – We may release your health information if asked to do so by law enforcement officials, so long as: 1) the information sought is relevant and material to a legitimate law enforcement inquiry, 2) the request for your information is specific and limited in scope, and 3) the request comes in the form of a warrant, subpoena, or summons issued by a court.
  • Coroners, Medical Examiners, and Funeral Directors –Health information may be released to a coroner, medical examiner, or funeral director. This may be necessary, for example, to identify a deceased person or to determine the cause of death.
  • Organ and Tissue Donation – If you are an organ or tissue donor, we may disclose your medical information to organizations that handle organ and tissue procurement, banking, or transplantation.
  • For research purposes – Under certain circumstances we may use and disclose your health information for research purposes. However, we will only disclose information that can be used to identify you when the research that is being conducted could not be conducted without the identifying information.
  • To avert a serious threat to health or safety – Our organization may use and disclose your medical information when necessary to reduce or prevent a serious threat to your health and safety or the health and safety of another individual or the public. Under these circumstances, we will only make disclosures to a person or organization able to help prevent the threat.
  • For specialized government functions – We may disclose medical information of military personnel and veterans in certain situations.
  • Workers’ Compensation – Our organization may release your health information to comply with laws relating to workers’ compensation and similar programs.
  • Appointment reminders – We may use and disclose your health information to remind you of a scheduled appointment or to provide you with information about treatment alternatives or other health-related benefits or services that may be of interest to you.
  • Authorizations: Other than the uses and disclosures described above, we will not use or disclose medical information about you without an authorization that is signed by you or, if you are unable to sign, by your personal representative. Before we disclose your health information, we will ask you to sign an authorization form that gives us permission to do so. You may later revoke (or cancel) your authorization in writing (except in very limited circumstances related to obtaining insurance coverage). If you would like to revoke your authorization, you may do so in writing and address to the Privacy Officer.


Under HIPAA, you have several specific rights regarding your health information.

  • Right to Request Access to Your Medical Information – With certain exceptions, you have the right to see and get a copy of your medical information that may be used to make decisions about your care. To see or to get a copy of your medical information, you must submit a written request. If you request a paper copy of your information, we may charge a fee for the cost of copying, mailing or other supplies associated with your request. There is no fee to see your medical information.
  • Right to Request Restrictions – You have the right to request that we change the way we use or disclose your medical information for treatment, payment, or health care operations. To request restrictions, you must make your request in writing. In your request, you must tell us: 1) What information you want to limit; 2) Whether you want to limit our use, disclosure or both; 3) To whom you want the limits to apply, for example, disclosures to your spouse. We are not required to agree to your request, except that we will not share your medical information with your health insurance company if you pay for the entire amount due for the services you receive (unless we are required by law to share the information with your health insurance company).
  • Right to Receive Confidential Communications – You have the right to request the manner in which, and where we communicate with you regarding your health information. For instance, you may ask that we contact you by mail rather than by telephone, or at home rather than at work. In order to receive a confidential communication or have information sent to a different location, you must provide the information at the time of registration or make your request in writing. In your request, you must specify the requested method of contact and/or the location as appropriate. The Facility will accommodate all reasonable requests.
  • Right to Request Amendment –If you feel that the medical information we have about you is incorrect or incomplete, you may ask us to amend the information. To request an amendment, you must submit a written request. Please be specific about the information that you believe is incorrect or incomplete.
  • Right to Receive an Accounting of Disclosures – You have the right to request an accounting of the disclosures the Facility makes of your health information. This accounting will not include any disclosures that the Facility makes for treatment, payment or healthcare operations. Your request for an accounting of disclosures must be submitted in writing. The first accounting of disclosures list you request in a twelve (12) month period will be provided free of charge. There will be a charge for any additional accountings of disclosures.
  • Right to be Notified of a Breach – We will notify you if we discover a breach of your unsecured protected health information.
  • Right to Obtain a Paper Copy of this Notice – You have the right to a paper copy of this notice. You may ask us to give you a copy at any time.
  • Right to File a Complaint – You will not be penalized for filing a complaint. If you believe your privacy rights have been violated, you may file a complaint with the facility by submitting your written complaint to the Privacy Officer.


Contact information for the Peterson Health Privacy Officer: 830-258-7343

Confidential HIPAA Hotline: 830-258-7889.

Privacy Officer, HIM Department

Peterson Health

551 Hill Country Drive

Kerrville, TX   78028


Effective Date: January 1, 2020

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