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Notice of Privacy Practices & No Surprises Act

This page provides information about Counseling Inspirations, PLLC's privacy practices, your rights regarding your protected health information (HIPPA), and your rights under the No Surprises Act, including Good Faith Estimates.

HIPPA Notice

PHI Information

Uses and Disclosures of PHI That May Be Made With Your Authorization or Opportunity to Object Unless you object, the Practice may disclose PHI:

  • To your family, friends, or others if PHI directly relates to that person's involvement in your care.

  • If it is in your best interest because you are unable to state your preference.

 

Uses and Disclosures of PHI Based Upon Your Written Authorization The Practice must obtain your written authorization to use and/or disclose PHI for the following purposes:

  • Marketing, sale of PHI, and psychotherapy notes.

 

You may revoke your authorization, at any time, by contacting the Practice in writing, using the information above. The Practice will not use or share PHI other than as described in Notice unless you give your permission in writing.

 

OUR RESPONSIBILITIES

  • The Practice is required by law to maintain the privacy and security of PHI.

  • The Practice is required to abide by the terms of this Notice currently in effect. Where more stringent state or federal law governs PHI, the Practice will abide by the more stringent law.

  • The Practice reserves the right to amend Notice. All changes are applicable to PHI collected and maintained by the Practice. Should the Practice make changes, you may obtain a revised Notice by requesting a copy from the Practice, using the information above, or by viewing a copy on the website.

  • The Practice will inform you if PHI is compromised in a breach.

To file a complaint if you feel your rights are violated

No Surprises Act

The No Surprises Act provides certain protections against unexpected medical bills. If you do not have health insurance or choose not to use your insurance to pay for your care, you may have the right to receive a Good Faith Estimate of expected charges before receiving services.

Good Faith Estimates

If you do not have health insurance or choose not to use your insurance to pay for your care, you have the right to receive a Good Faith Estimate of the expected charges for scheduled services.

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You may request a Good Faith Estimate before scheduling services or when scheduling services.

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Counseling Inspirations, PLLC will provide Good Faith Estimates as required by applicable federal law.

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Questions or requests: Please contact Counseling Inspirations, PLLC at 210.257.5560.

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Patient reminder: Keep a copy of your Good Faith Estimate and compare it with your final bill.

Patient-Provider Dispute Resolution

If you are uninsured or self-pay and your final bill is at least $400 more than your Good Faith Estimate, you may be eligible to dispute the bill through the federal Patient-Provider Dispute Resolution process.

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For more information about your rights under the No Surprises Act, visit the Centers for Medicare & Medicaid Services (CMS).

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