We do not accept insurance at this time. We opted to be out-of-network providers because your privacy is very important to us. Confidentiality and privacy are compromised when filing claims with insurance because a third party is involved in your treatment. In order to use your insurance coverage (out-of-network or in-network), you must qualify for a mental disorder diagnosis, which will become part of your permanent medical record. This information can also be viewed by employees of both the insurance company, managed care company, and potentially by your employers. This all puts your privacy at risk. Furthermore, insurance and managed care companies can decide if they think your treatment is “medically necessary” and even deny paying for services. They often impose limits on number of therapy sessions permitted as well.
By paying out of pocket, we can assure you the highest degree of privacy and flexibility. We do not have to share your protected health information with anyone (unless you specifically ask us to in writing). Our practice takes pride in providing appropriate mental health services to our patients. By not going through insurance, we are able to work together to determine the course of treatment which will be most helpful to you, rather than leaving that up to a representative from the insurance company.
We certainly understand financial constraints and the need to use health insurance, however. Upon request, we can provide you with receipts of payment that you may then submit to your insurance company for reimbursement of out-of-network services.
For information on our self-pay rates, please visit our Fees page.
How to Determine Your Out-of-Network Benefits:
If you would like to investigate the possibility of reimbursement for out-of-network coverage, please check your policy carefully and ask the following questions of your provider:
Are there out-of-network benefits for this policy?
Do I have a mental or behavioral health policy with out-of-network benefits?
Is prior authorization required?
Is a referral required from my primary care physician?
What is my out-of-network deductible and has it been met?
How much does my plan cover for an out-of-network mental health provider?
How do I obtain reimbursement for therapy or a psychological assessment with an out-of-network provider?
Is there a session limit, and how many sessions do I have left?
What percentage of services is covered?
What is the start date of the calendar year my out-of-network policy is based on?
Due to the nature of our small practice, we are not set up to respond immediately to a crisis. Please note we do not provide emergency services or 24-hour emergency on-call coverage. If you experience an emergency requiring immediate attention, please call 911 or go to your nearest hospital emergency room for assistance. You can also contact any of the following mental health hotline numbers:
National Suicide Prevention Lifeline: 1(800) 273-8255
National Suicide Prevention Lifeline (in Spanish): 1-888-628-9454 (En Español)
24/7 Crisis Text Line: Text “Start” to 741-741
National Sexual Assault Hotline: 1-800-656-HOPE(4673)
The National Domestic Violence Hotline: 1-800-799-7233
Please visit our Self-Help Resources page for more local and national resources.
You may call, email, or submit your inquiry through the contact form on our website. We typically have limited availability but will inform you if we have openings, or we may refer you to a local colleague if our schedules to do not match up. It’s helpful to schedule a brief phone call to make sure we are a good fit in terms of your specific needs, our scope of practice, and our availability/schedules. Once we determine we are a good fit, we will set up an appointment for your initial consultation (50-55 minute session).
Notice of Psychologists’ Policies and Practices to Protect the Privacy of Your Health Information
This information is made available so that you are fully aware of how psychological and medical information about you may be used and disclosed and how you can get access to this information.
I. Uses and Disclosures for Treatment, Payment, and Health Care Operations
Progressing Minds, PLLC may use or disclose your protected health information (PHI) for treatment, payment, and health care operations purposes with your consent. To clarify these terms, here are some definitions:
· PHI: refers to information in your health record that could identify you.
· Treatment: when Progressing Minds, PLLC provides, coordinates or manages your health care and other services related to your health care. An example of treatment would be when a Progressing Minds, PLLC provider consults with another health care provider, such as your family physician or another psychologist.
· Payment: is when we obtain reimbursement for your healthcare. Examples of payment are when we disclose your PHI to your health insurer to obtain reimbursement for your health care or to determine eligibility or coverage.
· Health Care Operations: are activities that relate to the performance and operation of our practice. Examples of health care operations are quality assessment and improvement activities, business-related matters such as audits and administrative services, and case management and care coordination.
· Use: applies to only activities within our office such as sharing, employing, applying, utilizing, examining and analyzing information that identifies you.
· Disclosure: applies to activities outside of our office such as releasing, transferring, or providing access to information about you to other parties.
II. Uses and Disclosures Requiring Authorization
We may use or disclose PHI for purposes outside of treatment, payment, or health care operations when your appropriate authorization is obtained. An “authorization” is written permission above and beyond the general consent that permits only specific disclosures. In those instances when we are asked for information for purposes outside of treatment, payment or health care operations, we will obtain an authorization from you before releasing this information. We will also need to obtain an authorization before releasing your Psychotherapy Notes. “Psychotherapy Notes” are notes we have made about our conversation during a private counseling session, which we have kept separate from the rest of your medical record. These notes are given a greater degree of protection than PHI.
You may revoke all such authorizations (of PHI or Psychotherapy Notes) at any time, provided each revocation is in writing. You may not revoke an authorization to the extent that (1) we have relied on that authorization; or (2) if the authorization was obtained as a condition of obtaining insurance coverage, law provides the insurer the right to contest the claim under the policy.
III. Uses and Disclosures with Neither Consent nor Authorization
We may use or disclose PHI without your consent or authorization in the following circumstances:
· Child abuse: If we have cause to believe that a child has been, or may be, abused, neglected, or sexually abused, we must make a report of such within 48 hours to the Texas Department of Protective and Regulatory Services, the Texas Youth Commission, or to any local or state law enforcement agency.
· Adult and Domestic Abuse: If we have cause to believe that an elderly or disabled person is in a state of abuse, neglect, or exploitation, we must immediately report such to the Department of Protective and Regulatory Services.
· Health Oversight Activities: If a complaint is filed against us with the State Board of Examiners of Psychologists, they have the authority to subpoena confidential mental health information from us relevant to that complaint.
· Judicial and Administrative Proceedings: If you are involved in a court proceeding and a request is made for information about your diagnosis and treatment and the records thereof, such information is privileged under state law, and we will not release information, without written authorization from you or your personal or legally appointed representative, or a court order. The privilege does not apply when you are being evaluated for a third party or where the evaluation is court ordered. You will be informed in advance if this is the case.
· Serious Threat to Health or Safety: If we determine that there is a probability of imminent physical injury by you to yourself or others, or there is a probability of immediate mental or emotional injury to you, we may disclose relevant confidential mental health information to medical or law enforcement personnel. If you are at risk, we may also contact family members or others who could assist in providing protection.
· Worker’s Compensation: If you have filed a worker’s compensation claim, we may be required to disclose records relating to your diagnosis and treatment to your employer’s insurance carrier.
IV. Patient’s Rights and Psychologist’s Duties
· Right to Request Restrictions: You have the right to request restrictions on certain uses and disclosures of protected health information about you. However, we are not required to agree to a restriction you request.
· Right to Receive Confidential Communication by Alternative Means and at Alternative Locations: You have the right to request and receive confidential communications of PHI by alternative means and at alternative locations. (For example, you may not want a family member to know that you are seeing us. Upon your request, Progressing Minds will send your bills to another address.)
· Right to an Accounting: You generally have the right to receive an accounting of disclosures of PHI. On your request, we will discuss with you the details of the accounting process.
· Right to Inspect, Amend, or Copy: You have the right to inspect, request an amendment or obtain a copy of your PHI for as long as the PHI is maintained in the record. We may deny you access to PHI under certain circumstances, such as when a health care professional believes access can cause harm to the individual or another person. In such situations, the individual must be given the right to have such denials reviewed. Upon your request we will discuss the details of the request and denial process. Covered entities may impose reasonable, cost-based fees for the cost of copying and postage.
· Right to a Paper Copy: You have the right to obtain a paper copy of the notice from us upon request, even if you have agreed to receive the notice electronically.
· We are required by law to maintain the privacy of PHI and to provide you with a notice of our legal duties and privacy practices with respect to PHI.
· We reserve the right to change the privacy policies and practices described in this notice. Unless we notify you of such changes, however, we are required to abide by the terms currently in effect.
· If we revise our policies and procedures, we will provide you with a revised notice by making it available at our office and on our website.
Progressing Minds will limit the uses or disclosures that we will make as follows: Release of raw test protocols (raw data) to anyone other than a qualified mental health professional, except in the case of a court order requiring us to release this data. Raw data refers to the actual test materials and recording forms on which the test responses and copyrighted test items are printed. This material is considered to be the property of the mental health professional, not the patient, since open access to the tests themselves can damage the validity of the test due to its content being exposed to the public. Exposing the test content to the public makes them potentially useless, as would exposing the items to the SAT, ACT or TAKS tests in educational settings. This practice is mandated by the Texas State Board of Examiners of Psychologists and the Texas State Board of Medical Examiners.
V. Questions and Complaints
If you have questions about this notice, disagree with a decision we make about access to your records, or have other concerns about your privacy rights, you may contact Progressing Minds, PLLC at (210) 239-1399.
If you believe that your privacy rights have been violated and wish to file a complaint, you may send your written complaint to Progressing Minds at the address given at the top of this document. You may also send a written complaint to the Secretary of the U.S. Department of Health and Human Services. Your doctor at Progressing Minds can provide you with the appropriate address upon request.
You have specific rights under the Privacy Rule. We will not retaliate against you for exercising your right to file a complaint.
This notice will go into effect on July 20th, 2017. A paper copy of this notice of privacy practices is available to you at any time upon request.
We reserve the right to change the terms of this notice and to make the new notice provisions effective for all PHI that we maintain. Progressing Minds will provide you with a revised notice either in person, by mail, or on our website.
The No Surprises Act requires health care providers and health care facilities to inform individuals who are uninsured or who are seeking services outside of their insurance plan to receive, both orally and in writing, a “Good Faith Estimate” (GFE) of expected charges.
The GFE shows the costs of items and services that are reasonably expected for services provided. The estimate is based on information known at the time the estimate was created.
You have the right to receive a Good Faith Estimate explaining how much your health care services will cost. Your psychologist at Progressing Minds will discuss your treatment goals and recommended session frequency during your initial consultation. We will revisit your therapy needs on an ongoing basis, with your collaboration. Your total cost of services will depend upon the number of therapy sessions you attend, your individual circumstances, and the type and amount of services that are provided to you. The GFE is not a contract and does not obligate you to obtain any services from Progressing Minds, PLLC, and you may discontinue treatment at any time.
For more information about your rights and protections against surprise health care bills, visit cms.gov/nosurprises/consumers.
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If you have a question that is not addressed on our website, we’d love to hear from you. Feel free to email, call us, or use the contact form on our website.