Patient Policies & Notices

1. HIPAA Notice of Privacy Practices

THIS NOTICE DESCRIBES HOW MEDICAL AND MENTAL HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

We understand that health information about you and your health care is personal. Patterns Psychiatry is committed to protecting health information about you. We create a record of the care and services you receive from us to provide you with quality care and to comply with legal requirements.

We are required by law to:

  • Make sure that protected health information (PHI) that identifies you is kept private.
  • Give you this notice of our legal duties and privacy practices.
  • Notify you if there is a breach of your unsecured PHI.

How We May Use and Disclose Your PHI: We may use your PHI for treatment, payment (including billing private insurance or TRICARE), and health care operations. We may also disclose PHI for public health activities, law enforcement purposes, or in response to a court order as required by state or federal law. Uses and disclosures for marketing, sale of PHI, or release of psychotherapy notes require your explicit written authorization.

Your Rights: You have the right to request restrictions on how we use your PHI, particularly if you pay for services out-of-pocket in full. You may request to receive confidential communications, inspect and copy your records, request an accounting of disclosures, and request corrections to your PHI.

Complaints: If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer, the U.S. Department of Health and Human Services (1-800-368-1019), or the Texas Office of the Attorney General (1-800-621-0508). You will not be retaliated against for filing a complaint.

‍

2. Good Faith Estimate (No Surprises Act)

You have the right to receive a “Good Faith Estimate” explaining how much your medical and mental health care will cost.

Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the expected charges for medical services, including psychotherapy and psychiatric evaluation.

  • You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency healthcare services.
  • You can ask your provider for a Good Faith Estimate before you schedule a service.
  • If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
  • Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit the Centers for Medicare & Medicaid Services (CMS) website.

‍

3. Texas Patient Records & Complaint Instructions

How to Request Your Records:

Under Texas law and HIPAA, you have the right to access and receive a copy of your medical records. All requests must be made in writing. Patterns Psychiatry will provide the requested records within fifteen (15) business days of receiving your completed written request. State law permits us to charge a reasonable, cost-based fee for copying records.

Notice Concerning Complaints (BHEC):

Counseling services are provided by Julie Hurt, Licensed Professional Counselor Associate, License #102193, supervised by Brunna Merrill, LPC-S (License #81478). The Texas Behavioral Health Executive Council investigates and prosecutes professional misconduct committed by professional counselors. To file a complaint, call 1-800-821-3205 or write to: Texas Behavioral Health Executive Council, 1801 Congress Ave., Ste. 7.300, Austin, Texas 78701.

‍