Medical Records – Health Information Management (HIM)

Process for Requesting Medical Record Copies:

All inpatient and intensive outpatient (IOP) medical records for La Hacienda Treatment Center, La Hacienda Solutions, and La Hacienda College Station patients can be requested from our central Medical Records Department located in Hunt, Texas. There is no cost for a copy of the medical record.

Download this form from our website, complete and sign** the “Authorization to Disclose Protected Health Information” form and return the completed form to us by U.S. Mail, Courier service such as FedEx or UPS, fax, or email to: [email protected].

**NO ELECTRONIC SIGNATURES accepted. Signature must match patient file.

Process for Revoking an Active Medical Record Authorization Request:

All revocation for active authorizations (not yet expired) for inpatient and intensive outpatient (IOP) medical records for La Hacienda Treatment Center, La Hacienda Solutions, and La Hacienda College Station patients can be sent to our central Medical Records Department located in Hunt, Texas. The revocation will begin as soon as the notice is received in our office.

Download this form from our website, complete and sign** the “Revocation of Authorization to Disclose Protected Health Information” form and return the completed form to us by U.S. Mail, Courier service such as FedEx or UPS, fax, or email to: [email protected].

**NO ELECTRONIC SIGNATURES accepted. Signature must match patient file.

Process for obtaining a pre-admission letter for screening or tentative program start date:

For use by all inpatient and intensive outpatient (IOP) patients at La Hacienda Treatment Center, La Hacienda Solutions, and La Hacienda College Station.

Download this form from our website, complete and sign** the “Authorization to Disclose Pre-Admission Letters” form and return the completed form to us by U.S. Mail, Courier service such as FedEx or UPS, fax, or email to: [email protected].

**NO ELECTRONIC SIGNATURES accepted.

Contact Information:
La Hacienda Treatment Center
Attn: Admissions
P.O. Box 1, Hunt, TX, 78024
P: (830) 238-4222
F: (830) 483-2232

Process for obtaining Payment and Reimbursement (Financial) Release form:

For use by all inpatient and intensive outpatient (IOP) patients at La Hacienda Treatment Center, La Hacienda Solutions, and La Hacienda College Station.

Download this form from our website, complete and sign** the “Authorization to Disclose Protected Health Information for Payment and Reimbursement Purposes” form and return the completed form to us by U.S. Mail, Courier service such as FedEx or UPS, fax, or email to: [email protected].

**NO ELECTRONIC SIGNATURES accepted.

Contact Information:
La Hacienda Treatment Center
Attn: Business Office
P.O. Box 1, Hunt, TX, 78024
P: (830) 238-4222
F: (830) 483-2232

Process for Requesting Billing Record Copies:

All inpatient and intensive outpatient (IOP) Billing Records for La Hacienda Treatment Center, La Hacienda Solutions, and La Hacienda College Station patients can be requested from our central Billing Department located in Hunt, Texas.

Download this form from our website, complete and sign** the “Authorization to Disclose Billing Records” form and return the completed form to us by U.S. Mail, Courier service such as FedEx or UPS, fax, or email to: [email protected].

**NO ELECTRONIC SIGNATURES accepted.

Contact Information:
La Hacienda Treatment Center
Attn: Billing
P.O. Box 1, Hunt, TX, 78024
P: (830) 238-4222
F: (830) 483-2232

Frequently Asked Questions for Inpatient and Outpatient Medical Record Copies

Is there a charge for a copy of my Medical Records?
No, there is not a charge for a copy of your medical records.

Can anyone get a copy of my medical records?
Patient records will ONLY be released by means of a completed “Authorization to Disclose Protected Health Information” form signed by the patient; a court order; or where the law requires us to do so.

How do I get a letter to verify that I was treated at La Hacienda (i.e. Certificate of Completion)?
Specify on the “Authorization to Disclose Protected Health Information” form that you would like such a letter by checking the selection titled “Attendance Letter”. This letter only includes the date of admission/discharge and your discharge status (such as “successfully completing the program”). This letter does not include your diagnosis or recommendations for after-care. Should you need these items added to the letter, please specify so on the authorization under the selection titled “Other” and we will create a letter based on your specific needs.

Will you send me my entire record?
With the patient’s written authorization, we will mail the entire record for the time period indicated to the address listed on the “Authorization to Disclose Protected Health Information” form. Entire (full) Medical Record requests will be sent by certified mail to the recipient address on the authorization.

Will you send my records via e-mail?
With the patient’s written authorization, we will email records through our secure portal to the email address listed on the “Authorization to Disclose Protected Health Information” form.

Will you send my records via fax?
With the patient’s written authorization, we will fax records to the fax number listed on the “Authorization to Disclose Protected Health Information” form only after we have called the source to confirm that the fax number is valid. Please note: We can only send 10 document pages via fax. Larger page counts will be mailed to the recipient.

How long does La Hacienda maintain my Medical Records (Inpatient/Outpatient)?
In accordance with Texas State Retention Laws, patient records are maintained for a period of (10) ten years from the time of discharge from the patient’s last visit date with us, regardless of location of services (Hunt, Austin, College Station). At the 10th anniversary date, the records are destroyed by a secure means.