Privacy Policy

Patient Notification of Data Collection

Pursuant to the 84th Texas Legislative Regular Session, HB 764, Section 108.0095

Notification of Data Collection

A provider shall provide to a patient whose data is being collected under this chapter written notice on a form prescribed by the department of the collection of the patient’s data for health care purposes. The notice provided under this section must include the name of the agency or entity receiving the data and of an individual within the agency or entity whom the patient may contact regarding the collection of data.

Facility/Provider: Concho County Hospital District

This document provides notice to patients that the Texas Department of State Health Services, Texas Health Care Information Collection program (THCIC), receives patient claim data regarding services performed by Concho County Hospital District.

Patient claim data is used to help improve the health of Texas through various methods of research and analysis. Patient confidentiality is held to the highest standard, and your information is not subject to public release. THCIC follows strict internal and external guidelines as outlined in Chapter 108 of the Texas Health and Safety Code and the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

For further information regarding the data being collected, please send all inquiries to:

Tarik Brown
Texas Health Care Information Collection (THCIC)
Texas Department of State Health Services
Center for Health Statistics, MC 1898
P.O. Box 149347
Austin, Texas 78714-9347

Location:
Moreton Building, M-660
1100 West 49th Street
Austin, TX 78756

Phone: 512-776-7261
Fax: 512-776-7740
Email: thcichelp@dshs.texas.gov

 

Concho County Hospital District Compliance Contact

Robert Pascasio

Chief Executive Officer
Concho County Hospital District

[INSERT ADDRESS]
[INSERT CITY, STATE ZIP]

Email: Administrator.RP@ConchoCH.com