NOTICE OF PRIVACY PRACTICES

​

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

Provider: Aaron Chapman, LPC-S or Heather Chapman, LPC
Practice Address: 3660 Stoneridge Rd., F102, Austin, TX 78746
Phone: (512) 265-5500

​

I. MY LEGAL DUTY

I am required by federal and Texas law to maintain the privacy of your Protected Health Information (PHI) and to provide you with this Notice of Privacy Practices, which explains my legal duties and privacy practices with respect to PHI. PHI is information in your health record that identifies you and relates to your mental or physical health, the health care services provided to you, or payment for those services.

I am required to follow the privacy practices described in this Notice while it is in effect. You have the right to obtain a paper copy of this Notice upon request, even if you have agreed to receive it electronically.

I reserve the right to change my privacy practices as permitted by law. If my privacy practices change, I will revise this Notice and make the updated version available in my office and through my electronic health record system (SimplePractice). The revised Notice will apply to all PHI I maintain.

​

II. USES AND DISCLOSURES OF PHI WITHOUT AUTHORIZATION

Under HIPAA, I may use or disclose your PHI without your authorization for the following purposes:

A. Treatment

I may use or disclose PHI to provide, coordinate, or manage your mental health care. This may include consultation with other health care providers involved in your care.

B. Payment

I may use or disclose PHI to obtain payment for services provided to you, including billing insurance companies, verifying benefits, and collections activities.

C. Health Care Operations

I may use or disclose PHI for activities necessary to operate my practice, such as quality assurance, administrative services, audits, licensing, and compliance reviews.

​

III. USES AND DISCLOSURES REQUIRING AUTHORIZATION

I will obtain your written authorization before using or disclosing your PHI for purposes other than treatment, payment, or health care operations, unless otherwise permitted or required by law.

Psychotherapy Notes

Psychotherapy notes are notes I create documenting or analyzing the content of our counseling sessions and keep separate from your medical record. Psychotherapy notes receive special protection under HIPAA and Texas law and will not be released without your written authorization, except as permitted by law.

You may revoke an authorization in writing at any time, except to the extent that action has already been taken in reliance on the authorization.

​

IV. USES AND DISCLOSURES WITHOUT AUTHORIZATION OR CONSENT (AS REQUIRED OR PERMITTED BY LAW)

A. Mandatory Reporting – Abuse and Neglect

• Child Abuse or Neglect: If I have reason to believe a child has been abused or neglected, I am required to report this to the Texas Department of Family and Protective Services (DFPS) or appropriate law enforcement.

• Elderly or Disabled Adult Abuse: If I believe an elderly or disabled person is being abused, neglected, or exploited, I must report this to DFPS.

B. Duty to Protect / Serious Threats

If I determine there is a serious and imminent risk of physical harm to you or others, I may disclose relevant PHI to appropriate medical or law enforcement personnel or others reasonably able to prevent the harm, as permitted by Texas law.

C. Health Oversight Activities

PHI may be disclosed to health oversight agencies, including the Texas Behavioral Health Executive Council (BHEC), for audits, investigations, inspections, licensure, or disciplinary proceedings.

D. Judicial or Administrative Proceedings

PHI may be disclosed in response to a court order, subpoena, or other lawful process as permitted by Texas law. Mental health records are generally privileged, and disclosures will be limited to what is legally required.

E. Workers’ Compensation

If you file a workers’ compensation claim, I may disclose PHI related to that claim as authorized by law.

V. YOUR RIGHTS REGARDING YOUR PHI

You have the following rights under HIPAA and Texas law:

1. Right to Inspect and Obtain a Copy

You have the right to inspect or obtain a copy of your PHI in your designated record set, except for psychotherapy notes and information compiled for legal proceedings. Requests must be made in writing.

2. Right to Request Amendment

You may request an amendment to your PHI if you believe it is inaccurate or incomplete. I may deny your request under certain circumstances.

3. Right to an Accounting of Disclosures

You have the right to receive an accounting of certain disclosures of your PHI made without your authorization.

4. Right to Request Restrictions

You may request restrictions on certain uses or disclosures of your PHI. I am not required to agree to all requested restrictions.

5. Right to Restrict Disclosure to Health Plans

If you pay for a service out-of-pocket in full, you may request that I not disclose PHI related to that service to your health plan. I must honor this request unless disclosure is otherwise required by law.

6. Right to Request Confidential Communications

You may request that communications be sent to you by alternative means or at alternative locations. Requests must be made in writing.

7. Right to Receive Electronic Copies

If your PHI is maintained electronically, you have the right to receive an electronic copy and to request that it be transmitted to a designated third party.

8. Right to Notification of a Breach

You have the right to be notified if there is a breach of unsecured PHI involving your information.

​

VI. QUESTIONS OR COMPLAINTS

If you have questions about this Notice or your privacy rights, you may contact:

Aaron Chapman, LPC
Phone: (512) 265-5500

If you believe your privacy rights have been violated, you may file a complaint with me or with:

Texas Behavioral Health Executive Council (BHEC)
1801 Congress Ave., Ste. 7.300
Austin, TX 78701
Phone: 1-800-821-3205

Website: https://www.bhec.texas.gov

You may also file a complaint with the U.S. Department of Health and Human Services. I will not retaliate against you for filing a complaint.

​​