To stop or start messages
- STOP
Text STOP to cancel at any time. We reply once to confirm, then stop. - START
Text START to join again.
Stopping text messages does not change your care. If you stop appointment reminders, we will contact you about appointments by phone, mail, or the patient portal instead, so please keep those details current.
1. What this covers
These terms cover every text message, also called SMS, that START Center for Cancer Care sends, whether we send it directly or through a vendor acting on our behalf. Each separate message stream is called a program below.
The programs are separate. Appointment reminders and billing messages are part of your care and your account, so they are sent to the mobile number you give The START Center for Cancer unless you tell us not to. Feedback, review, and marketing messages are sent only if you ask for them. Any of them can be stopped on its own or all at once.
The START Center for Cancer may add, change, or retire a program. When that happens we republish this page with a new revision number and effective date, and we give notice before a material change takes effect.
The START Center for Cancer uses third party messaging platforms, message aggregators, and wireless carriers to deliver these messages. Any vendor that handles protected health information for START does so under a written business associate agreement meeting 45 CFR 164.504(e). Wireless carriers act as conduits for transmission.
2. The programs, and what each one needs from you
Two of these are part of your care and your account and are on by default. One is optional and is off until you ask for it.
| Program | What you receive | Default |
| Appointment and care reminders | Confirmations, reminders, reschedule requests, pre-visit instructions, check-in links, care coordination messages from your team | On. Sent to the number you give START for use in your care. Decline at any time. |
| Billing and payment | Statement ready, balance due, payment or refund confirmation, payment plan notices, secure portal links | On. Sent to the number you give START in connection with your care and account. Decline at any time. |
| Feedback, reviews, and marketing | Survey invitations after a visit, optional requests to share feedback publicly, news about START programs, services, clinical trials, screening opportunities, classes, events | Off. Requires your opt-in, plus a signed HIPAA marketing authorization. |
Appointment and care reminders, sent unless you decline
These are treatment and health care operations communications under 45 CFR 164.501 and 164.506. Giving START your mobile number for use in your care serves as your consent to receive them, so there is nothing to opt in to. You can decline them on the enrollment form, in the patient portal, by texting STOP, or by telling any member of START staff. If you decline, we will contact you about appointments by phone, mail, or the patient portal instead.
Billing and payment, sent unless you decline
These are payment communications under 45 CFR 164.501 and 164.506, and the mobile number you give START in connection with your care and your account serves as your consent to receive them. You can decline them the same ways described above. If you decline, we will send statements and account notices by mail, by phone, or through the patient portal.
Feedback, reviews, and marketing, sent only if you ask
When you opt in, you agree to receive text messages related to feedback and reviews, and text messages about START programs, services, clinical trials, screening opportunities, classes, and events. The feedback and review part is a quality assessment and improvement activity, which is a health care operation under 45 CFR 164.501. The marketing part uses your health information for marketing, so START must also obtain a written authorization meeting 45 CFR 164.508(a)(3), which is part of the START Consent and Notice of Privacy Practices Acknowledgment. Your authorization lasts two years, you may revoke it in writing at any time, any message a third party paid for will say so, and information sent under it may lose federal privacy protection once you receive it. START never sells your health information (45 CFR 164.502(a)(5)(ii); Texas Health and Safety Code Section 181.006).
Your care never depends on any of this
START will not condition your treatment, payment, enrollment in a health plan, or eligibility for benefits on whether you agree to receive text messages, consistent with 45 CFR 164.508(b)(4). If you decline every program, we will reach you by phone, mail, or the patient portal.
You must be 18 or older, or the parent, legal guardian, or personal representative of a patient you are legally authorized to act for. The number you give must be one you own or normally use.
3. What applies to every text message
By giving START your mobile number, and by opting in where an opt-in is required, you agree to receive the messages described above at that number, including messages sent using an automatic telephone dialing system or comparable technology.
Message frequency
Message frequency varies by program and depends on your appointments, your account activity, and your choices. Typical frequency is shown in the table above. Message frequency may vary.
Message and data rates
As always, message and data rates may apply for any messages sent to you from us and to us from you. Message frequency may vary. If you have any questions about your text plan or data plan, it is best to contact your wireless provider.
Devices and delivery
You need a mobile device and a wireless plan that can send and receive SMS text messages. Delivery depends on your wireless carrier and is not guaranteed. Carriers are not liable for delayed or undelivered messages.
4. Stopping messages, and joining again
You can cancel the SMS service at any time. Just text “STOP”. After you send the SMS message “STOP” to us, we will send you an SMS message to confirm that you have been unsubscribed. After this, you will no longer receive SMS messages from us. If you want to join again, reply “START” and we will start sending SMS messages to you again.
START treats STOP broadly. If you are enrolled in more than one program, we stop all of them at that number unless you tell us to stop only one. The confirmation message explains how.
You can also withdraw your consent any other reasonable way, including by phone, by email, in writing, through the patient portal, or by telling any member of START staff. We will act on your request promptly, and no later than ten business days after we receive it.
Opting out ends text messages only. It does not affect your care, your appointments, your account, or your rights as a patient. If you stop appointment reminders or billing messages, we will use phone, mail, or the patient portal instead, so please keep those details current.
Texting STOP ends marketing texts, and also ends feedback and review texts, because those are consented together. To revoke the underlying HIPAA marketing authorization entirely, send a written revocation to the START privacy officer.
5. Message content and your health information
Messages contain only the minimum information needed for the purpose, following 45 CFR 164.502(b) and 164.514(d). They will not include your diagnosis, test results, medications, or treatment details. Appointment messages are limited to things like date, time, location, and the department or provider you are scheduled to see. Billing messages are limited to things like the existence of a balance or statement and where to view it securely.
Standard text messages are not encrypted. Anyone with access to your phone, your wireless account, or a device linked to that account may be able to read them. By giving START a mobile number and not declining these messages, you accept that risk for the limited message content described here.
Under 45 CFR 164.522(b) you may ask START to contact you by a different method or at a different location. We will accommodate reasonable requests.
Tell START if your mobile number changes or you stop using it, so messages are not sent to a number that has been reassigned to someone else.
6. What START will never ask for by text
Text messages are not monitored continuously and are not part of your clinical record. Please do not use them to report symptoms, request medication, or seek urgent advice. Call your START care team, or call 911 in an emergency.
START will never ask you to send a credit or debit card number, a bank account number, a Social Security number, or a password by text message. Do not send that information by text to START or to anyone claiming to be START.
Payments are taken only through the secure START payment portal, by phone with START staff, or by mail. A legitimate START billing text will send you to the START portal or ask you to call a START number.
If a message asks for payment information directly, or the link or phone number looks unfamiliar, do not respond. Contact START using the details in section 9 to check whether it came from us.
7. Reviews you choose to post publicly
If you use a feedback message to post a review on a public website, what you write there is public and is no longer protected health information held by START. Please do not include details about your condition or treatment that you would not want others to see.
START will not confirm that you are a patient, and will not disclose any protected health information, in a public reply to a review, unless you have signed a separate written authorization that meets 45 CFR 164.508.
Using your name, image, or story in START marketing material requires its own authorization and is not covered by these terms
8. Privacy of your mobile number and opt-in data
START Center for Cancer Care will not share consumer opt-in data and consent with any third parties for their own use case; excluding aggregators and providers of the Text Messaging services.
START does not sell your health information (45 CFR 164.502(a)(5)(ii); Texas Health and Safety Code Section 181.006). START does not sell, rent, lease, or otherwise make your mobile number, your opt-in status, or your consent record available to any third party for that party’s own marketing purposes.
Your mobile number and consent record are shared only with the vendors that run these programs and deliver the messages, as described in section 1.
Under Texas Health and Safety Code Section 181.154, START obtains separate authorization before electronically disclosing protected health information for any purpose other than treatment, payment, health care operations, or as otherwise required or authorized by law.
START keeps the record of each enrollment, each authorization, and each opt-out request for the period required by 45 CFR 164.530(j)(2) and applicable Texas medical record retention rules.
9. Contact
Billing and payment questions
210-593-5711 · billpay@thestartcenter.com
START privacy officer
Travis Ryals, (210) 593-5872, Privacy@thestartcenter.com
START Center for Cancer Care, 4383 Medical Dir, San Antonio, Texas 78229
10. How this fits with our other privacy documents
These terms add to, and do not replace, the START Notice of Privacy Practices and the START privacy policy. The Notice of Privacy Practices explains how START uses and discloses your health information and what rights you have. It is posted at every START location and available on request.
If anything here conflicts with the Notice of Privacy Practices on a matter involving protected health information, the Notice of Privacy Practices controls.
11. Changes and governing law
START may revise these terms, including the program table. The current version and its effective date are shown at the top of this page. If a change materially affects a program, we will give notice before it takes effect.
These terms are governed by the laws of the State of Texas. The programs are operated in accordance with HIPAA and its regulations at 45 CFR Parts 160 and 164, the Telephone Consumer Protection Act at 47 USC 227 and 47 CFR 64.1200, Texas Health and Safety Code Chapter 181, and Texas Business and Commerce Code Chapters 302, 304, and 521, as applicable.
