Notice of Electronic Disclosure

Deborah (Dheva) Liebman, M.A., LPC

Texas License #82763

Deborah (Dheva) Liebman is a Covered Entity and must comply with the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), the Health Information Technology for Economic and Clinical Health Act (“HITECH” or the “HITECH Act”), and Chapters 181 and 182 of the Texas Health & Safety Code.  Please note that Chapter 181 of the Texas Health and Safety Code defines the term “Covered Entity” more broadly than does HIPAA in 45 C.F.R. §160.103. Covered entities as defined by Chapter 181 are required to comply with the applicable Chapter 181 provisions. If Deborah (Dheva) Liebman obtains or creates information about your health, Deborah (Dheva) Liebman is required by law to protect the privacy of your information. Protected health information (“PHI”) includes any information that relates to:

Your past, present, or future physical or mental health or condition;

Health care provided to you; and,

Past, present, or future payment for your health care.

Deborah (Dheva) Liebman may not disclose your PHI electronically without your authorization unless allowed by law. For example, the practice may share your PHI through approved, secure electronic methods for the purpose of treatment, payment for health care services, or health care operations such as case management or care coordination.

Deborah (Dheva) Liebman may not disclose PHI electronically without separate authorization from you or your personal representative for each disclosure unless the disclosure is for treatment, payment, health care operations, an insurance or HMO function, or as otherwise authorized under state or federal law.

For a complete list of reasons that Deborah (Dheva) Liebman is allowed by law to share your PHI, please refer to the Notice of Privacy Practices. This Notice will be provided upon the first date of delivery of health care services to you and is available upon request.