This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
Our duties
Eki Mental Health PLLC is required by law to maintain the privacy of your Protected Health Information (PHI), provide you with notice of our legal duties and privacy practices, and abide by the terms of the notice currently in effect. We must notify you in the event of a breach of unsecured PHI as required by federal and state law.
Uses and disclosures we may make without your authorization
- Treatment. To provide, coordinate, or manage your psychiatric care, including consultation with other clinicians treating you.
- Payment. To bill insurance, verify benefits, and collect payment for services.
- Health care operations. To run our practice, including quality assurance, training, and audits.
- Required by law. When required by federal, state, or local law (court orders, subpoenas, public health reporting).
- Public health and safety. Mandated reporting of suspected child or elder abuse; serious threats to health or safety; communicable disease reporting.
- Workers' compensation, judicial proceedings, law enforcement, deceased patients (50-year limit), organ donation, research with IRB approval, military and national security, inmate situations, and other situations specifically permitted by HIPAA.
Uses and disclosures requiring your written authorization
- Marketing communications.
- Sale of PHI.
- Most uses and disclosures of psychotherapy notes.
- Any use or disclosure not described above.
You may revoke an authorization in writing at any time, except to the extent we have already acted in reliance on it.
Heightened-protection categories
- Substance Use Disorder records protected under 42 CFR Part 2 require specific authorization for most disclosures.
- HIV / AIDS records require separate written authorization under Tex. Health & Safety Code §81.103.
- Mental health records are subject to additional protections under Tex. Health & Safety Code §611.
- Psychotherapy notes receive enhanced federal protection.
Your rights
- Access: obtain a copy of your medical record (paper or electronic) — typically within 15 days under Texas law.
- Amendment: request that we correct information you believe is inaccurate.
- Accounting of disclosures: receive a list of certain disclosures we have made.
- Restrictions: request limits on how we use or disclose your PHI; we are required to honor a request to restrict disclosures to your health plan when you have paid out of pocket in full (HITECH §13405(a)).
- Confidential communication: request that we contact you in a specific way (e.g., only by mail).
- Paper copy: obtain a paper copy of this notice at any time.
- Breach notification: receive notification if there is a breach of your unsecured PHI.
- Complaint without retaliation: file a complaint with us or with HHS without fear of retaliation.
Telehealth-specific notice (22 TAC §174.4)
Texas requires that you receive — and acknowledge — this notice before your first telemedicine encounter. You will be asked to acknowledge receipt of this notice (electronically or in writing) during intake. Acknowledgment can be revoked at any time and does not waive any of your rights described above.
How to exercise your rights or file a complaint
Contact our Privacy Officer:
Dr. Isi Etakibuebu, Privacy Officer
Eki Mental Health PLLC
Austin, TX 78758
Phone: 512-729-3088
You may also file a complaint with:
- U.S. Department of Health and Human Services Office for Civil Rights: hhs.gov/ocr/privacy/hipaa/complaints · 1-800-368-1019 · TTY 800-537-7697 · 200 Independence Ave SW, Room 509F HHH Bldg, Washington DC 20201.
- Texas Medical Board: 333 Guadalupe, Tower 3, Suite 610, P.O. Box 2018, MC-263, Austin, TX 78768-2018; 1-800-201-9353; tmb.state.tx.us.
- Texas Board of Nursing: 333 Guadalupe, Suite 3-460, Austin, TX 78701-3944; 1-800-821-3205; bon.texas.gov.
Changes to this notice
We reserve the right to change this notice and to make the new provisions effective for all PHI we maintain. Updated notices will be posted to this page and provided in the next visit packet.