Notice of Privacy Practices

Perfectly Mental LLC is required by law to maintain the privacy of your protected health information (PHI), to provide you with this Notice of our legal duties and privacy practices with respect to your PHI, and to notify you following a breach of unsecured PHI. We are required to abide by the terms of this Notice currently in effect. We reserve the right to change the terms of this Notice and to make the new Notice effective for all PHI we maintain. If we make a material change to this Notice, we will post the revised Notice on our website and make it available upon request.

This Notice is provided in compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA), as amended, and the Texas Medical Records Privacy Act, Texas Health and Safety Code Chapter 181.

How We May Use and Disclose Your Health Information

The following describes the ways we may use and disclose your PHI. Not every use or disclosure in a category will be listed, but all of the ways we are permitted to use and disclose information will fall within one of the categories below.

Treatment

We may use your PHI to provide, coordinate, or manage your mental health treatment. For example, we may share your information with other healthcare providers involved in your care, such as your primary care physician, psychiatrist, or other treating clinicians, when necessary to coordinate your treatment.

Payment

We may use and disclose your PHI to obtain payment for services provided to you. For example, we may submit claims to your insurance company or a third-party payer and include information about your diagnosis and treatment.

Healthcare Operations

We may use and disclose your PHI for our internal operations, such as quality assessment, training, licensing, and business management functions necessary to operate our practice.

Required by Law

We will disclose your PHI when required to do so by federal, state, or local law, including mandatory reporting requirements under Texas law.

Public Health and Safety

We may disclose your PHI to prevent or lessen a serious and imminent threat to your health or safety or the health or safety of another person or the public. We may also disclose PHI to public health authorities as required by law.

Abuse, Neglect, or Domestic Violence

As required by Texas law, we are mandatory reporters. We are required to report suspected abuse or neglect of a child, elderly person, or person with a disability to the appropriate authorities, regardless of client consent.

Judicial and Administrative Proceedings

We may disclose your PHI in response to a court or administrative order, subpoena, discovery request, or other lawful process.

Uses and Disclosures Requiring Your Authorization

Other uses and disclosures of your PHI not described in this Notice will be made only with your written authorization. Under Texas Health and Safety Code §181.154, we are required to obtain your written authorization before releasing your PHI to most third parties. You may revoke any authorization you provide at any time, in writing, except to the extent that we have already taken action in reliance on your authorization.

We will not use or disclose your psychotherapy notes without your specific written authorization, except as permitted by law. We will not sell your PHI or use it for marketing purposes without your written authorization.

Your Rights Regarding Your Health Information

You have the following rights with respect to your PHI. To exercise any of these rights, please submit a written request to the contact information listed at the end of this Notice.

Right to Access Your Records

You have the right to inspect and obtain a copy of your PHI that we maintain in a designated record set. We may charge a reasonable fee for copying. We will respond to your request within 15 business days. In limited circumstances, we may deny your request; if so, you may request a review of the denial.

Right to Amend Your Records

If you believe that information in your record is incorrect or incomplete, you may request that we amend it. We may deny your request if the information was not created by us, is not part of the records we maintain, or is accurate and complete. If we deny your request, you have the right to submit a written statement of disagreement.

Right to an Accounting of Disclosures

You have the right to request a list of disclosures of your PHI that we have made for purposes other than treatment, payment, healthcare operations, and certain other exceptions, for the six years prior to your request.

Right to Request Restrictions

You have the right to request that we restrict how we use or disclose your PHI for treatment, payment, or healthcare operations. We are not required to agree to your request unless the restriction involves disclosures to a health plan for payment or operations purposes and you have paid for the service out of pocket in full. If we agree to a restriction, we will honor it unless the information is needed to provide emergency treatment.

Right to Confidential Communications

You have the right to request that we communicate with you about your PHI in a certain way or at a certain location. For example, you may request that we contact you only at a specific phone number or address. We will accommodate reasonable requests.

Right to a Paper Copy of This Notice

You have the right to receive a paper copy of this Notice at any time, even if you have agreed to receive it electronically. To request a paper copy, contact us using the information below.

Right to Opt Out of Fundraising Communications

If we ever use your PHI for fundraising purposes, you have the right to opt out of receiving such communications.

Breach Notification

We are required by law to notify you if there is a breach of your unsecured PHI. A breach is generally an impermissible use or disclosure of your PHI that compromises its privacy or security. In the event of a breach, we will notify you without unreasonable delay and no later than 60 days after we discover the breach. Notification will be provided by first-class mail to your last known address, or by email if you have agreed to receive electronic notices.

If the breach affects 500 or more residents of Texas, we will also notify the Texas Attorney General as required by Texas Health and Safety Code §181.105. For breaches affecting 500 or more individuals nationally, we will notify the Secretary of the U.S. Department of Health and Human Services and, in some cases, prominent media outlets in the affected area.

How to File a Complaint

If you believe your privacy rights have been violated, you have the right to file a complaint with us or with the appropriate government authorities. We will not retaliate against you for filing a complaint.

File a Complaint with Perfectly Mental

To file a complaint with our practice, please submit your complaint in writing to:

We will acknowledge receipt of your complaint and respond within a reasonable time. All complaints will be investigated and addressed in good faith.

File a Complaint with the U.S. Department of Health and Human Services

You may also file a complaint with the Office for Civil Rights (OCR) of the U.S. Department of Health and Human Services:

File a Complaint with the Texas Attorney General

For violations of the Texas Medical Records Privacy Act, you may file a complaint with the Texas Attorney General’s Office:

Our Duties

We are required by law to maintain the privacy of your PHI, to provide you with this Notice of our legal duties and privacy practices, and to notify you following a breach of unsecured PHI. We are required to abide by the terms of this Notice currently in effect.