Notice of Privacy Practices

This Notice of Privacy Practices describes how information about you may be used and disclosed, and how you can access this information. Please review it carefully.
1. Our Commitment to Your Privacy
We are committed to protecting the privacy of your Protected Health Information (PHI). PHI includes information that identifies you and relates to your mental health care, treatment, or payment for services. We are required by law to maintain the privacy of your PHI and to provide you with this Notice explaining our legal duties and privacy practices.
We are required by law to:

• Maintain the privacy and security of your PHI
• Provide you with this Notice of Privacy Practices
• Follow the terms of the Notice currently in effect

2. Uses and Disclosures of Protected Health Information
A. For Treatment
Your PHI may be used and shared as necessary to provide mental health treatment. This may include consultation with other healthcare providers involved in your care.
B. For Payment
We may use and disclose PHI to bill and collect payment for services. Insurance will be billed as appropriate, based on the information you provide. Please note:

• Insurance reimbursement is not guaranteed.
• Clients are responsible for all copays, coinsurance, deductibles, and any balances not covered by insurance.

C. For Healthcare Operations
PHI may be used for administrative purposes, quality assurance, licensing, and compliance activities necessary to operate the practice.
3. Confidentiality of Therapy Sessions
All therapy sessions are confidential and protected under HIPAA and applicable state laws. Information disclosed during sessions will not be shared without your written authorization except as required or permitted by law.
Confidential information may be disclosed without your consent in the following situations:

• When there is a risk of serious harm to you or others
• Suspected abuse or neglect of a child, elder, or dependent adult
• When required by court order, subpoena, or other legal mandate

4. Release of Information
Any disclosure of PHI outside of treatment, payment, or healthcare operations requires a written Release of Information (ROI) signed by you. You may revoke an authorization in writing at any time, except to the extent that action has already been taken based on your authorization.
5. Appointment Cancellations & Scheduling Policy
Regarding appointments, the following practice policies apply:

• A minimum of 24 hours notice is required to cancel or reschedule an appointment.
• Appointments canceled with less than 24 hours’ notice will incur a late cancellation fee of the full amount of the session.
• No-shows are subject to a charge of the full amount of the session.
• To avoid a late cancellation fee, canceled sessions must be rescheduled within the same calendar week, subject to availability.
• Late cancellation and no-show fees are not covered by insurance and are the client’s responsibility.

6. Your Rights Regarding Your PHI
You have the right to:

• Request access to your medical and billing records
• Request corrections to inaccurate or incomplete information
• Request restrictions on certain uses or disclosures (we are not required to agree)
• Request confidential communications (such as alternative contact methods)
• Receive a paper or electronic copy of this Notice

Requests must be made in writing.
7. Changes to This Notice
We reserve the right to change this Notice and make the revised Notice effective for all PHI we maintain. Any updates will be posted on this website and made available upon request.
8. Complaints
Complaints must be submitted using the Council’s complaint form. The completed form can be sent by email to Enforcement@bhec.texas.gov or by mail to 1801 Congress Avenue, Suite 7.300, Austin, Texas 78701.