CLINICA HISPANA BERRY
96 BERRY RD. HOUSTON, TEXAS, 77022
Ph: (713) 492-2661 Fax: (712) 492-2718

Commitment to Privacy

The appropriate collection, use, and disclosure of patients’ personal health information is fundamental to our day-to-day operations and patient care.

Protecting patient personal information's privacy and confidentiality is important to our providers and staff at Clinica Hispana Berry.

We strive to provide our patients with excellent medical care and service. Every member of the team must abide by our commitment to privacy in handling personal information. This policy was last modified on February 1, 2024.

Applicability of This Privacy Policy

Our Privacy Policy attests to our commitment to privacy and demonstrates how we ensure that patient privacy is protected. It applies to the personal health information of all our patients that is in our possession and control.

What is Personal Health Information?

Personal health information means identifying information about an individual relating to their physical or mental health (including medical history), the provision of health care to the individual, payments or eligibility for health care, organ and tissue donation, and health number.

The 10 Principles of Privacy

Our Privacy Policy reflects our compliance with fair information practices, applicable laws, and standards of practice.

1. Accountability

We take our commitment to securing patient privacy very seriously. Each physician and employee associated with the Practice is responsible for the personal information under his/her control. Our employees are informed about the importance of privacy and receive information periodically to update them about our Privacy Policy and related issues.

2. Identifying Purposes: Why We Collect Information

We ask you for information to establish a relationship and serve your medical needs. We obtain most of our information about you directly from you or from other health practitioners whom you have seen and authorized to disclose to us. You are entitled to know how we use your information, and this is described in the Privacy Statement posted at Clinica Hispana Berry. We will limit the information we collect to what we need for those purposes and use it only for those purposes. We will obtain your consent if we wish to use your information for any other purpose.

3. Consent

You have the right to determine how your personal health information is used and disclosed. For most healthcare purposes, your consent is implied due to your consent to treatment; however, express consent must be written in all circumstances.

Your written consent form will be forwarded to the privacy officer, who will document the request in the patient’s medical records and notify appropriate Healthcare providers and their supporting staff.

Patients who have withdrawn consent to disclose PHI must sign and date the Consent to Withdrawal Form. It is understood that the consent directive applies only to the PHI that the patient has already provided and not to PHI that the patient might provide in the future: PHIPA permits specific collections, uses, and disclosures of the PHI, despite the consent directive; healthcare providers may override the consent directive in certain circumstances, such as emergencies; and the consent directive may result in delays in receiving health care, reduced quality of care due to healthcare provider’s lacking complete information about the patient, and healthcare provider’s refusal to offer non-emergency care. Your written Consent to Withdrawal Form will be forwarded to the Privacy Officer, who will document the request in the patient’s medical records and notify appropriate Health care providers and their supporting staff.

4. Limiting Collection

We collect information by fair and lawful means and collect only that information that may be necessary for purposes related to the provision of your medical care.

5. Limiting Use, Disclosure and Retention

The information we request from you is used for the purposes defined. We will seek your consent before using the information for purposes beyond the scope of the posted Privacy Statement.

Under no circumstances do we sell patient lists or other personal information to third parties. However, some types of disclosure of your personal health information may occur as part of this Practice fulfilling its routine obligations and/or practice management. This includes consultants and suppliers to the Practice, on the understanding that they abide by our Privacy Policy and only to the extent necessary to allow them to provide business services or support to this Practice.

We will retain your information only for the time it is required for the purposes we describe. Once your personal information is no longer required, it will be destroyed. However, due to our ongoing exposure to potential claims, some information is kept for a longer period.

Patients may be required to sign and date a Consent to Disclose PHI Form and pay a fee based on current OMA rates before information is released.

6. Accuracy

We endeavor to ensure that all decisions involving your personal information are based upon accurate and timely information. While we will do our best to base our decisions on accurate information, we rely on you to disclose all material information and to inform us of any relevant changes.

7. Safeguards: Protecting Your Information

We protect your information with appropriate safeguards and security measures. The Practice maintains personal information in a combination of paper and electronic files. Recent paper records concerning individuals’ personal information are kept in files kept onsite at our office, while older records may be stored securely offsite.

Access to personal information will be authorized only for the physicians and employees associated with the Practice and other agents who require access in the performance of their duties and to those otherwise authorized by law.

We provide information to healthcare providers acting on your behalf on the understanding that they are also bound by law and ethics to safeguard your privacy. Other organizations and agents must agree to abide by our Privacy Policy and may be asked to sign contracts. We will give them only the information necessary to perform the services they are engaged in and will require that they not store, use, or disclose the information for purposes other than to carry out those services.

Our computer systems are password-secured and constructed so only authorized individuals can access secure systems and databases.

If you send us an email message with personal information, such as your name in the "address," we will use that information to respond to your inquiry. Please remember that email is not necessarily secure against interception. If your communication is very sensitive, you should not send it electronically unless the email is encrypted or your browser indicates the access is secure.

8. Openness: Keeping You Informed

The Practice has prepared this plain-language Privacy Policy to keep you informed. You may view a copy by visiting our website at www.clinicahispanaberry.com

If you have any additional questions or concerns about privacy, we invite you to contact us by phone, and we will address your concerns to the best of our ability.

9. Access and Correction

With limited exceptions, we will provide you with access to the information we retain about you within a reasonable time upon presentation of a written request and satisfactory identification.

We may charge you a fee for this service; if so, we will give you notice before processing your request.

If you find errors of fact in your personal health information, please notify us as soon as possible, and we will make the appropriate corrections. We are not required to correct information relating to clinical observations or opinions made in good faith. You have a right to append a short statement of disagreement to your record if we refuse to make a requested change.

If we deny your request for access to your personal information, we will advise you in writing of the reason for the refusal, and you may then challenge our decision.

10. Challenging Compliance

We encourage you to contact us with any questions or concerns about your privacy or our Privacy Policy. We will investigate and respond to your concerns about any aspect of our handling of your information.

Usually, an issue is resolved simply by telling us about it and discussing it. You can reach us at:

Hermes D. Hernandez Alfonso FNP-C
Clinica Hispana Berry
96 Berry Rd.
Houston, Texas 77022
Ph: (713) 492-2661
Fax: (712) 492-2718

If, after contacting us, you feel that your concerns have not been addressed to your satisfaction, you have the right to complain by contacting the DSHS Privacy Office by mail at Mail Code 1919, P.O. Box 149387 Austin, TX 78714; by telephone at (512) 776-6502; or by email hipaa.privacy@dshs.texas.gov.

You may also file a complaint by contacting the Office for Civil Rights, Region VI, U.S. Department of Health and Human Services, by mail at 1301 Young St., Suite 1169, Dallas, Texas 75202; by telephone at (800) 368-1019, (214) 767-0432 (fax), or (800) 537-7697 (TDD).

You can also visit https://www.hhs.gov/ocr/privacy/hipaa/complaints.

For complaints about a violation of your right to confidentiality by an alcohol or drug abuse treatment program, contact the United States Attorney’s Office for the judicial district in which the violation occurred.

We will not retaliate against you for filing a complaint.