HIPAA NOTICE OF PRIVACY PRACTICES

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

OUR LEGAL DUTY

Houston Healing Collective is required by federal law, specifically the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and its implementing regulations, to maintain the privacy of your protected health information. We are required to provide you with this Notice of Privacy Practices and to abide by the terms of this Notice as currently in effect.

We reserve the right to change the terms of this Notice and to make any revised Notice effective for all protected health information we maintain, including information we received prior to the revision. If we make material changes to this Notice, we will post the updated version on our website at houstonhealingcollective.co. You may request a printed copy of the current Notice at any time by contacting us.

WHAT IS PROTECTED HEALTH INFORMATION (PHI)

Protected health information, or PHI, is any information we create, receive, or maintain about you that relates to your physical or mental health, the healthcare services we provide to you, or payment for those services, and that could be used to identify you. Examples of PHI include your name, address, date of birth, diagnosis, clinical notes, treatment records, and billing records.

HOW WE MAY USE AND DISCLOSE YOUR PHI WITHOUT YOUR WRITTEN AUTHORIZATION

Federal law permits us to use and disclose your PHI for the following purposes without obtaining your written authorization.

Treatment. We may use and disclose your PHI to provide, coordinate, and manage your care and related services. This may include sharing relevant clinical information with other healthcare providers involved in your treatment, such as your primary care physician, psychiatrist, nutritionist, or other members of your care team, with your knowledge and as clinically appropriate.

Payment. Houston Healing Collective does not submit claims to insurance carriers directly. We may, however, provide you with itemized superbills or statements that include your diagnosis, services rendered, and session dates, which you may choose to submit to your insurance plan for potential out-of-network reimbursement. Any third-party platforms used to process payments or generate billing documents are identified in the Third-Party Platforms section of this Notice.

Healthcare Operations. We may use and disclose your PHI for internal operations, including quality improvement activities, clinical supervision, case consultation among our clinical staff, staff training, and administrative purposes. Clinical supervision and internal case consultation involve sharing relevant case information within our practice in a manner designed to support clinical care while protecting your privacy.

Houston Healing Collective operates as a collaborative group practice in which clinicians receive ongoing supervision and consultation from Jennifer Lancaster, LCSW-S, our clinical director.

As Required by Law. We may disclose your PHI when required to do so by applicable federal, state, or local law.

Mandatory Reporting. Under Texas law, we are required to report to the Texas Department of Family and Protective Services, or other appropriate authorities, any reasonable suspicion of abuse, neglect, or exploitation of a child under the Texas Family Code, and any reasonable suspicion of abuse, neglect, or exploitation of an elderly or disabled adult under the Texas Human Resources Code. These disclosures are made without your authorization and, in some circumstances, without prior notice to you.

Serious Threat to Health or Safety. We may disclose PHI when necessary to prevent or reduce a serious and imminent threat to the health or safety of a person or the public, consistent with our professional and ethical obligations and applicable Texas law, including our duty to warn obligations.

Psychotherapy Notes. Separately maintained psychotherapy notes receive special protection under HIPAA. We will not use or disclose your psychotherapy notes without your written authorization except as required by law, for our own training purposes, or to defend ourselves in legal proceedings you initiate against us.

USES AND DISCLOSURES REQUIRING YOUR WRITTEN AUTHORIZATION

Any use or disclosure of your PHI not described in this Notice requires your prior written authorization. This includes, but is not limited to, the use or disclosure of your PHI for marketing purposes, the sale of your PHI, and any other purpose not permitted or required under HIPAA.

You have the right to revoke any authorization you have provided at any time, provided your revocation is submitted to us in writing. A revocation will not apply to actions we have already taken in reliance on your authorization before we received your written revocation.

YOUR RIGHTS REGARDING YOUR PHI

You have the following rights with respect to your protected health information held by Houston Healing Collective.

Right to Access. You have the right to inspect and obtain copies of your health and billing records. We will provide access or copies within 30 days of receiving your written request. A reasonable copying fee may apply. To submit a request, contact us at hello@houstonhealingcollective.co or by mail at 6300 West Loop South, Bellaire, Texas 77401.

Right to Amendment. If you believe that information in your records is inaccurate or incomplete, you may submit a written request for correction. We will respond within 60 days. We may deny a request for amendment in certain circumstances and will provide the reason for any denial in writing.

Right to an Accounting of Disclosures. You may request a written list of the disclosures we have made of your PHI outside of treatment, payment, and healthcare operations purposes during the preceding six years. Your first request within any 12-month period is provided at no charge. Subsequent requests within the same period may be subject to a reasonable fee.

Right to Request Restrictions. You may request that we limit how we use or disclose your PHI. We are not required to agree to every requested restriction, but we will consider all requests. If we agree to a restriction, we will honor it except in cases of emergency treatment.

Right to Confidential Communications. You may request that we contact you using a specific method or at a specific location, such as by email only or at an alternate phone number. We will accommodate all reasonable requests.

Right to a Copy of This Notice. You have the right to receive a paper copy of this Notice at any time upon request. Contact us at hello@houstonhealingcollective.co or 346-281-1654.

To exercise any of the rights described above, please contact us in writing at hello@houstonhealingcollective.co or Houston Healing Collective, 6300 West Loop South, Bellaire, Texas 77401. We will respond within 30 days of receiving your request.

THIRD-PARTY PLATFORMS THAT HANDLE YOUR PHI

The following platforms may access, store, or transmit your protected health information as part of our practice operations. We maintain a Business Associate Agreement with each platform that handles PHI and require each to comply with HIPAA.

Electronic Health Records and Practice Management: Therapy Notes. This platform stores and processes your protected health information including clinical notes, appointment records, and billing details. Therapy Notes is HIPAA-compliant and we maintain a Business Associate Agreement with them. For more information, visit privacy policy.

Telehealth Platform through Therapy Notes. We conduct telehealth video sessions using Therapy Notes, a HIPAA-compliant video platform. We maintain a Business Associate Agreement with Therapy Notes. For more information, visit privacy policy.

Payment Processing through Therapy Notes. We use Therapy Notes to process self-pay session payments. For more information, visit privacy policy.

DATA RETENTION

We maintain your clinical records in accordance with HIPAA and applicable Texas law. Adult clinical records are retained for a minimum of seven years from the date of last service. Records for clients who were minors at the time of service are retained until the client reaches age 18, plus a minimum of two years thereafter, or for any longer period required by applicable law.

Financial and billing records are retained for a minimum of seven years.

At the end of the applicable retention period, records are destroyed using secure methods that protect your privacy and comply with HIPAA requirements.

DATA SECURITY

Houston Healing Collective implements appropriate administrative, physical, and technical safeguards to protect the privacy and security of your protected health information in compliance with the HIPAA Security Rule. These safeguards include encryption of data in transit using TLS and SSL protocols, encryption of data at rest where technically feasible, access controls and credential management for all clinical staff, and ongoing staff training on privacy and security practices. We require all vendors and business associates who handle your PHI to enter into a Business Associate Agreement and to maintain their own HIPAA-compliant security practices.

BREACH NOTIFICATION

In the event of a breach of unsecured protected health information, we will notify you in writing within 60 days of discovering the breach, as required by the HIPAA Breach Notification Rule. Our notification will describe the nature of the breach, the types of information involved, steps you may take to protect yourself, what we are doing to investigate and address the breach, and contact information for follow-up questions. We will also report the breach to the U.S. Department of Health and Human Services Office for Civil Rights as required by federal law.

HOW TO FILE A COMPLAINT

If you believe that your privacy rights under HIPAA have been violated, you may contact us directly:

Houston Healing Collective Attention: Jennifer Lancaster, LCSW-S 

6300 West Loop South, Bellaire, Texas 77401 Phone: 346-281-1654 Email: hello@houstonhealingcollective.co

You also have the right to file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights at hhs.gov/ocr/privacy/hipaa/complaints or by calling 1-800-368-1019.

We will not retaliate against you in any way for filing a complaint.

GOOD FAITH ESTIMATE - NO SURPRISES ACT

As of January 1, 2022, under the federal No Surprises Act, you have the right to receive a written Good Faith Estimate of the expected cost of your care before your first appointment if you are uninsured or if you choose not to use your insurance benefits.

Under this law, healthcare providers are required to give patients a written estimate including the expected charges for the services you are scheduled to receive. You have the right to dispute a bill that is at least $400 more than the Good Faith Estimate you received.

Current session fees for Houston Healing Collective providers are as follows.

Jamie Weiser, LMFT-A Individual Therapy, 45 minutes: $130 Individual Therapy, 60 minutes: $155 Family and Couples Therapy, 50 minutes: $155 Initial Assessment, 60 minutes: $155 Initial Assessment, 90 minutes (required for ketamine services): $210 Ketamine Therapy (Therapy Portion Only), 2 hours: $260 Ketamine-Assisted Couples Therapy (Therapy Portion Only), 2 hours: $300

Rachel Chang, LMSW Individual Therapy, 45 minutes: $130 Individual Therapy, 60 minutes: $155 Family and Couples Therapy, 50 minutes: $155 Initial Assessment, 60 minutes: $155 Initial Assessment, 90 minutes (required for ketamine services): $210 Ketamine Therapy (Therapy Portion Only), 2 hours: $260 Ketamine-Assisted EMDR (Therapy Portion Only): $155 per hour

Beatrice Paksa, LMSW Individual Therapy, 45 minutes: $130 Individual Therapy, 60 minutes: $155 Family and Couples Therapy, 50 minutes: $130 Initial Assessment, 60 minutes: $155 Initial Assessment, 90 minutes (required for ketamine services): $210 Ketamine Therapy (Therapy Portion Only), 2 hours: $260

Jennifer Lancaster, LCSW-S Individual Therapy, 45 minutes: $205 Individual Therapy, 60 minutes: $230 Family and Couples Therapy, 50 minutes: $230 Initial Assessment, 60 minutes: $230 Initial Assessment, 90 minutes (required for ketamine services): $325 Ketamine Therapy (Therapy Portion Only), 2 hours: $400 Ketamine-Assisted EMDR (Therapy Portion Only): $230 per hour

Group Therapy, 60 minutes: $65 Clinical Supervision and Consultation: $65 per hour (group supervision), $185 per hour (individual clinical supervision)

Private Practice Business Consultation: $230 per hour

To request a written Good Faith Estimate prior to your first appointment, contact us at hello@houstonhealingcollective.co or 346-281-1654. For more information about your rights under the No Surprises Act, visit cms.gov/nosurprises or call 1-800-985-3059.

UPDATES TO THIS NOTICE

We reserve the right to change the terms of this Notice at any time. Any changes will apply to all PHI we maintain, including records created prior to the effective date of the revision. The most current version of this Notice will be posted at houstonhealingcollective.co and is available in printed form upon request at our office.

Effective Date: May 21, 2026