HIPAA Notice of Privacy Practices

Effective Date: 17th Feb, 2026

THIS NOTICE EXPLAINS HOW YOUR MEDICAL INFORMATION MAY BE USED AND SHARED, AND HOW YOU MAY ACCESS THIS INFORMATION. PLEASE READ IT CAREFULLY.

HIPAA Notice of Privacy Practices

Understanding This Notice

Your trust matters to ER of Watauga. Federal regulations mandate that we safeguard your health information and clearly explain how we handle it. This Notice covers all medical records generated or stored at our facility: 5401 Basswood Blvd, Fort Worth, TX 76137.

We maintain electronic health records and may transmit your protected health information electronically to other healthcare providers, labs, insurance companies, and other entities as described in this Notice.

We must adhere to the practices outlined here while this Notice remains active. We may update our privacy practices and this Notice as needed. Updated versions apply to both existing records and new information. The current Notice is posted at our facility and at erofwatauga.com.

Defining Protected Health Information

Protected Health Information (PHI) is any identifiable data connected to your health status, treatment at our facility, or payment for that care. This includes medical history, physical examination notes, diagnostic results, treatment documentation, and billing information.

Uses of Your Health Information

Treatment Purposes

Your health data enables us to provide emergency medical services. We share pertinent information with doctors, nurses, lab technicians, and clinical personnel treating you. When you need care beyond our capabilities, we coordinate with hospitals and specialists for transfers.

Example: A patient presenting with stroke symptoms may have their CT scan and neurological assessment shared with a receiving stroke center.

Payment Activities

We utilize your health information for billing and payment collection. This includes confirming insurance eligibility, filing claims, and resolving payment inquiries with your insurer.

Example: A claim submitted to your insurance company may contain diagnosis codes, procedures performed, and medications administered.

Healthcare Operations

Your records support activities that maintain care quality—clinical reviews, staff education, compliance audits, and accreditation processes.

Example: Your chart may be reviewed during quality assessments evaluating our emergency care protocols.

Disclosures Permitted Without Authorization

State and federal laws authorize or mandate disclosure in these situations:

Legal Requirements: When compelled by federal, state, or local law, court orders, or subpoenas.

Public Health Purposes: To public health agencies for disease control, injury reporting, or medication/device adverse event tracking.

Abuse and Neglect Reports: To government authorities when child abuse, elder abuse, or domestic violence is suspected.

Health Oversight: To oversight agencies conducting audits, investigations, or facility inspections.

Judicial Proceedings: Responding to valid court orders or subpoenas with proper safeguards.

Law Enforcement: Identifying crime victims, reporting suspicious deaths, or responding to legitimate law enforcement inquiries.

Threat Prevention: When disclosure could prevent or mitigate serious, imminent danger to you or others.

Organ Donation: To organ procurement organizations, eye banks, or tissue programs for potential donors.

Death Investigation: To medical examiners or coroners for identification or cause of death determination.

Workers’ Compensation: For work-related injury or illness claims under applicable laws.

Armed Forces: For military personnel, as military authorities require.

Government Functions: For national security, intelligence activities, or protection of government officials.

Inmates: To correctional facilities or officials responsible for incarcerated individuals’ health and safety

Your Rights

Authorization Requirements

Uses and disclosures beyond those described require your written authorization. You may withdraw authorization anytime by written request to our Privacy Office. Withdrawal does not affect prior disclosures made with your permission.

Special protections apply to psychotherapy notes, paid marketing communications, and sale of health information—these always require explicit written authorization.

Your Privacy Rights

Record Access

You may obtain copies of your medical records by written request to our Privacy Office. Reasonable copying and mailing fees may apply. Texas law requires response within 15 business days.

Amendment Requests

If you find errors or gaps in your record, you may request corrections. Denial may occur if we did not create the information, do not maintain it, or find it accurate. Denied requests may include your written disagreement statement in the record.

Restriction Requests

You may ask us to limit uses or disclosures for treatment, payment, or operations, or restrict sharing with family members involved in your care. Most restrictions are discretionary. However, we must honor requests to withhold information from health plans for services you paid out-of-pocket in full.

Communication Preferences

You may specify how and where we contact you—for instance, calling your mobile instead of home phone, or mailing to an alternate address. We honor reasonable requests.

Disclosure Accounting

You may request a list of disclosures made during the prior six years. This excludes treatment, payment, operations, and authorized disclosures. One accounting per 12-month period is free; fees may apply for additional requests.

Paper Copy

Request a printed copy of this Notice anytime, regardless of prior electronic receipt.

Breach Notification

We will notify you as legally required if your unsecured health information is breached, detailing what occurred, information involved, protective steps, our investigation, and contact information.

Our Obligations

ER of Watauga is legally required to:

  • Protect the privacy and security of your health information
  • Furnish this Notice of our legal duties and privacy practices
  • Comply with this Notice’s current terms
  • Inform you when we cannot accommodate restriction requests
  • Honor reasonable confidential communication requests
  • Notify you of any breach involving your unsecured health information
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Complaints

If you believe your privacy rights were violated, file a complaint with us or the U.S. Department of Health and Human Services. No retaliation will occur for filing complaints.

ER of Watauga Contact

Privacy Office 5401 Basswood Blvd Fort Worth, TX 76137
Phone: (817) 945-5500
Email: info@erofwatauga.com

Federal Contact

U.S. Department of Health and Human Services Office for Civil Rights 1301 Young Street, Suite 106 Dallas, TX 75202

Website: https://www.hhs.gov/ocr/about-us/contact-us/index.html

Questions About This Notice?

If you’ve any questions or need further information about this notice or your privacy rights, please contact ER of Watauga’s Privacy Office using the above details.

This Notice takes effect on the date above and remains valid until replaced.

This notice is posted in compliance with the Health Insurance Portability and Accountability Act (HIPAA) and the Texas Medical Records Privacy Act, Chapter 181 of the Texas Health and Safety Code.

 

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