No Surprises Act
The No Surprises Act is a federal law designed to protect clients like you from surprise bills for out-of-network services. It ensures you have access to clear information about the costs of your care before receiving services.
You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services.
You can request a Good Faith Estimate before you first appointment or any time during the course of treatment.
If you receive a bill that is at least $400 more than your Good FaithEstimate, you can dispute the bill.
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises
Client Rights and Consumer Information
This notice is provided in compliance with Texas state licensing requirements and Section 181.105 of the Texas Health and Safety Code.
Requesting Health Care Records
Consumers may request access to their health care records maintained by this practice.
To request health care records:
Submit a written request to Donielle Garcia Psychotherapy, PLLC (you can use the contact form on this website, send a letter to the listed address, or call 832-930-1844 for assistance).
Requests are processed in accordance with applicable state and federal law.
Fees may apply.
Contact the Texas Behavioral Health Executive Council
Consumers may contact the Texas Behavioral Health Executive Council regarding licensed behavioral health providers.
Texas Behavioral Health Executive Council
Website: https://bhec.texas.gov/
Filing a Consumer Complaint
Consumers may file a complaint with the Office of the Texas Attorney General Consumer Protection Division.
To file a complaint, visit:
https://www.texasattorneygeneral.gov/consumer-protection
The Attorney General’s office provides instructions and online forms for submitting consumer complaints.