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Notice of Privacy Practices

How health information about you may be used and disclosed, and how you can obtain access to it. Effective [EFFECTIVE DATE].

AS REQUIRED BY FEDERAL LAW, THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN OBTAIN ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Our commitment

Tentie Psychiatry, LLC uses and discloses the information collected from you only as permitted by HIPAA, the HITECH Act and the laws of the State of Texas. This covers your treatment, payment and healthcare operations. Your personal health information will not be given to anyone else — including family members — without your written consent, except as described in this notice.

The HIPAA Privacy Officer for this practice is José M. Torrijos, MD.

Disclosures that require your authorisation

Psychotherapy notes carry additional protections under HIPAA, and an authorisation is required for most uses or disclosures of them. Because this practice files no insurance claims, no clinical information is routinely transmitted to any health plan. Authorisation is also obtained before using or disclosing your information in any way not described here, for marketing purposes, or in any way that would constitute a sale of protected health information.

Routine uses and disclosures

  1. For treatment — including consultation with another provider involved in your care, such as your primary care physician or therapist.
  2. For payment — so that services may be billed and payment collected.
  3. For healthcare operations — administrative functions necessary to run the practice, including sharing with business associates such as an electronic health record or telehealth vendor, all of whom are contractually bound to protect your information.
  4. Communicating with you — appointment reminders by voicemail, text or email, and sharing with a friend or family member involved in your care where you have not asked otherwise.

Special situations

Information may be disclosed without your authorisation where required by law; for health oversight activities; in judicial or administrative proceedings subject to state privilege protections; to avert a serious and imminent threat to health or safety; in workers’ compensation proceedings; for public health activities including the reporting of abuse or neglect; to law enforcement in the narrowly defined circumstances the Privacy Rule permits; and in other situations specified in Section 164.512 of the Privacy Rule and Texas confidentiality law.

Your rights as a patient

  1. To request restrictions on certain uses and disclosures.
  2. To receive confidential communications by a method or at a location you specify.
  3. To inspect and obtain copies of your information, subject to the exceptions the Privacy Rule allows.
  4. To request an amendment where you believe information is incorrect or incomplete.
  5. To receive an accounting of disclosures not covered by the routine uses above.
  6. To obtain a paper copy of this notice on request.
  7. To restrict disclosure to a health plan where you have paid out of pocket in full — which, in this private-pay practice, applies to all services.
  8. To be notified if there is a breach of your unsecured protected health information.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with this practice or with the Secretary of the U.S. Department of Health and Human Services at 1-800-368-1019. All complaints must be submitted in writing. You will not be penalised, and your care will not be affected, for filing one.

Changes to this notice

This notice may be revised, and revised provisions will apply to all information the practice maintains. Updates are sent electronically to active patients and a current copy is always available here and at the office.

Contact

José M. Torrijos, MD · Tentie Psychiatry, LLC · [STREET ADDRESS], [CITY, TX ZIP] · [PHONE] · [EMAIL]

Demonstration site

This page reproduces the structure and substance of the practice’s Notice of Privacy Practices. The controlling document is the signed PDF provided to patients, which requires review by a Texas health attorney before use.

Ready when you are

Request an appointment and we will get back to you within one business day. No obligation, and nothing is decided before you understand it.