- Clinic Timing: Mon-Wed-Thu 8am to 5pm
- Tues: 8am to 4pm
- Fri: 8am to 12pm
This Notice of Privacy Practices outlines how your medical information may be used and disclosed and how you can gain access to it. Please read it carefully. If you have any questions, feel free to contact us at (817) 200-6680 or via email at info@tricitypsychiatric.com.
Your health information is personal, and Tri City Psychiatric Services prioritizes its protection. We will not sell, trade, or misuse your personal information. This notice describes the types of uses and disclosures we may make regarding your protected health information (PHI), as well as your rights to access and control this information.
“Protected health information” (PHI) refers to any data about you, including demographic information, that could identify you and pertains to your health, healthcare services, or payment for these services.
We may use and disclose your PHI to provide healthcare services, process payments, support our healthcare operations, and comply with legal requirements. The following are specific ways we may use or disclose your information without written consent:
Treatment: We may use and disclose PHI to provide, coordinate, or manage your health care, including with third parties, as needed. For example, if you are referred to a specialist, we may share your information with them to ensure continuity of care.
Payment: Your PHI may be used to secure payment for services provided. This includes sharing information with your insurance company to confirm eligibility or coverage, obtain pre-authorization for treatments, or ensure payment for services rendered.
Healthcare Operations: We may use PHI to support Tri-City Psychiatric Services’ business activities. These activities include quality assessments, staff training, and compliance with regulatory requirements. For example, we may disclose your information to trainees in our office or use a sign-in sheet at the reception desk. We may also contact you to remind you of your appointment.
Business Associates: We may share your PHI with third-party business associates who perform essential functions for our practice, such as billing, legal services, and transcription. We have contracts with these associates to ensure the protection of your PHI.
Communications: Tri-City Psychiatric Services may use or disclose PHI for communication purposes, such as appointment reminders, billing inquiries, and prescription-related discussions. We may reach you via email, phone, text, or postal mail based on your contact preferences.
Other Permitted Uses: We may disclose your PHI in specific situations without your authorization, including:
In cases where your PHI is used or disclosed beyond these situations, we will seek your written authorization. You may revoke this authorization at any time by contacting us in writing, except to the extent that we have already taken action based on the authorization.
You have specific rights related to your PHI, including:
Tri City Psychiatric Services reserves the right to modify this Privacy Policy as permitted or required by law. Updates will be posted on our website and will become effective immediately upon posting.
If you believe your privacy rights have been violated, you can file a complaint with us at feedback@tricitypsychiatric.com or contact us by phone at (817) 200-6680. You may also submit a complaint to the Secretary of the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.
Our office is open Monday through Friday (Timing: Mon-Wed-Thu 8 am to 5 pm / Tues: 8 am to 4 pm / Fri: 8 am to 12 pm), and we are closed on all major holidays. We do not offer emergency, crisis, weekend, or after-hours services. In case of a life-threatening emergency, please go to the nearest emergency room or dial 911 immediately.
Appointments for Refills: A virtual or in-person appointment is required for prescription refills. Please ensure that follow-up appointments are scheduled before you run out of your current prescription, as refills and medication adjustments are only made during these appointments.
Appointment Compliance: Regular attendance at appointments is essential to prevent interruptions in your treatment, which may lead to an increased risk of relapse.
Controlled Substance Policy: For controlled substances, prescription refills may be contingent on drug screening results (UDS) as directed by your provider.
Medication Storage: Patients are responsible for securely storing medications, especially controlled substances, in a locked location. Lost, stolen, or damaged medications or instances of running out early will not result in replacement prescriptions.
Schedule 2 Prescriptions: All Schedule 2 prescriptions require 24-48 hours for processing, as mandated by Texas regulations. This time frame allows for necessary reviews, including chart evaluations and Texas PMP checks. Expedited processing is not available.
Medication Prior Authorization: We recommend bringing a copy of your insurance formulary list to your appointment. This helps us prescribe medications covered by your insurance and explore alternatives if needed, minimizing potential out-of-pocket costs.
In certain cases, we may need to order lab work. Please note that lab costs are not included in our visit charges. You may choose any lab provider you prefer, but it is your responsibility to confirm costs with them directly.
Consent for Communication Methods: By providing your contact information, including phone number and email address, you consent to our use of these methods for communication purposes. We may contact you via phone calls, voicemail, and SMS/text messaging regarding scheduling, billing, prescription refills, and other service-related matters.
Electronic Communication Security: We use encryption and safeguards to protect electronic communications on our end. However, it is your responsibility to ensure that your communication devices are secure. This includes setting a PIN for voicemail, using strong passwords for email accounts, and securing text messages with device lock features or secure messaging apps.
Responsibility for Privacy in Communication: If you are concerned about the security of electronic communication on your devices, please consider alternative communication methods with us. Ensuring mutual understanding about these practices is essential for maintaining your confidentiality.
Insurance Responsibilities: Patients are responsible for all medical expenses incurred. We verify insurance benefits as a courtesy, but this is not a guarantee of coverage or payment. Patients should be familiar with their insurance policy details and cover any charges not paid by insurance.
Credit Card Authorization: Patients authorize Tri City Psychiatric Services to keep a credit card on file for any unpaid services, including fees for missed appointments, late cancellations, or requested paperwork.
Initial Psychiatric Evaluation: $200
Follow-Up for Medication Management: $95
FMLA Paperwork Completion: $50.00 for each form filled, and pre payment required. Please submit the paperwork before your appointment.
Cancellation and No-Show Policies
24-Hour Cancellation Policy: Please cancel at least 24 hours in advance to avoid fees. Insurance does not cover missed appointment fees.
Tri City Psychiatric Services does not provide services in the areas of Forensic or Occupational Psychiatry. We do not engage in cases involving:
If you need a copy of your medical record, please submit a signed authorization form with the payment. It may take up to 15 business days to process and release your records.
Call me if any questions, 405-4737661
I understand that Doctors / Therapists do not appear in court to defend patients/clients; for any reason, if there is a subpoena, the client will be responsible for paying $1,500.00 for half a day or $3,000.00 for a full day in court. Payment will need to be collected in advance.
Tri City Psychiatric Services is committed to protecting patient confidentiality in accordance with Texas law. However, there are several exceptions, including:
If you have any questions about confidentiality or exceptions, please discuss them with your provider.
If, in the clinical judgment of your provider, you are deemed a danger to yourself or others, you consent by signing this policy for the provider to contact your emergency contact or another appropriate individual to assist during the crisis.
Both the patient and the provider reserve the right to terminate the treatment relationship at any time. If the provider decides to discontinue treatment, the patient will be informed promptly, and referrals for continued care will be provided.
If clinically appropriate and safe, the provider may issue a limited supply of emergency medications; however, this does not include Schedule II controlled substances.
Any emergency medication provided is subject to the provider’s professional discretion and compliance with applicable regulations.
