NOTICE OF PRIVACY PRACTICES

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Garcia Psychiatry & Wellness, PLLC d/b/a TESSERA Psychiatry

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Effective Date: July 13, 2026

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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.

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This notice applies to TESSERA Psychiatry, a private-pay psychiatric practice serving children, adolescents, and adults who are physically located in Texas at the time of care.

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Your Rights

- Access your record. You may ask to inspect or receive an electronic or paper copy of your medical record. We generally respond to a proper written Texas medical-record request within 15 business days and may charge a lawful, reasonable fee.

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- Request a correction. You may ask us to amend information you believe is incorrect or incomplete. We may deny the request in some situations, but we will explain the decision in writing.

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- Request confidential communications. You may ask us to contact you in a particular way or at a different address. We will honor reasonable requests as required by law.

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- Request limits. You may ask us to limit certain uses or disclosures. We are not always required to agree. If you pay in full out of pocket, you may ask us not to disclose that service to a health plan for payment or operations unless disclosure is required by law.

Receive an accounting of disclosures. You may request a list of certain disclosures made during the previous six years, excluding disclosures for treatment, payment, health care operations, and certain other exceptions.

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- Receive a paper copy. You may request a paper copy of this notice at any time, even if you received it electronically.

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- Choose or have a personal representative. A parent, legal guardian, or other person legally authorized to act on your behalf may exercise privacy rights on your behalf to the extent permitted by law after we verify that person's authority.

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- File a complaint. You may complain to TESSERA Psychiatry or to the U.S. Department of Health and Human Services Office for Civil Rights. We will not retaliate against you for filing a complaint.

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Children, Adolescents, and Personal Representatives

For patients who are minors, a parent or legal guardian will generally act as the patient's personal representative and may have access to the minor's health information as permitted by law.

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There are circumstances in which Texas or federal law allows a minor to consent to certain health care services independently or otherwise provides additional confidentiality protections. In those circumstances, the minor may have privacy rights regarding information related to that care, and a parent or guardian may not automatically have access to all information.

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TESSERA Psychiatry will follow applicable federal and Texas law when determining whether a parent, guardian, minor patient, or other personal representative may access, authorize disclosure of, or exercise rights concerning a minor patient's protected health information.

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When clinically appropriate and consistent with applicable law, TESSERA Psychiatry seeks to respect an adolescent patient's privacy while appropriately involving parents or guardians in treatment, safety planning, and medical decision-making.

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Your Choices

- You may tell us whether and how to share information with family members, close friends, caregivers, or others involved in your care or payment for your care.

 

- For minor patients, these choices may be exercised by the patient, parent, guardian, or other legally authorized representative depending on who has authority under applicable law.

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- If you cannot express a preference, we may share limited information when permitted by law and when we reasonably believe doing so is in your best interest or necessary to reduce a serious and imminent threat.

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- Written authorization is generally required for marketing, the sale of your information, and most uses or disclosures of psychotherapy notes. You may revoke an authorization in writing, except to the extent we have already relied on it.

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- TESSERA Psychiatry does not sell protected health information or use it for fundraising.

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How We May Use and Disclose Your Information

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- Treatment

We may use your information to evaluate and treat you and may share it with other health professionals involved in your care, including pharmacies, laboratories, therapists, physicians, and other clinicians, when permitted by law. For minor patients, treatment-related information may also be shared with a parent, guardian, or other person legally authorized to participate in the patient's care when permitted or required by law.

 

- Payment

We may use or disclose information to collect payment, process transactions, provide receipts or billing records, and address payment questions. TESSERA Psychiatry is a private-pay practice and does not routinely submit claims to insurance companies.

At your request, we may provide appropriate documentation, such as a superbill or itemized receipt, that you may choose to submit independently to your health plan for possible out-of-network reimbursement. Any reimbursement is determined by your health plan and is not guaranteed by TESSERA Psychiatry.

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- Health Care Operations

We may use information to operate the practice, coordinate services, improve quality, train staff, conduct compliance activities, manage technology, and communicate about appointments or care.

Business Associates. We may share information with vendors that perform services for us, such as our electronic health record, telehealth platform, secure communications services, payment processor, legal or accounting professionals, and information-technology or record-management services. When required by law, these vendors must protect your information through a business associate agreement or other applicable privacy protections.

 

Other Uses Permitted or Required by Law

Subject to applicable conditions and limits, we may use or disclose information for purposes permitted or required by federal or Texas law, including:

• Public health and safety activities

• Reporting suspected abuse, neglect, or exploitation

• Preventing or reducing a serious and imminent threat to health or safety

• Health oversight activities

• Workers' compensation and similar programs

• Research when legally permitted

• Organ and tissue donation

• Coroners, medical examiners, or funeral directors

• Certain law-enforcement or government functions

• Judicial or administrative proceedings

• Other disclosures required or permitted by law

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For children and adolescents, TESSERA Psychiatry will comply with applicable mandatory-reporting requirements concerning suspected child abuse or neglect and other legally required disclosures.

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Extra Protections for Sensitive Records

Texas law provides additional confidentiality protections for mental-health communications and records. We follow the more protective federal or Texas rule when it applies.

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We generally will not disclose confidential mental-health treatment information without appropriate authorization unless disclosure is permitted or required by law, such as for treatment, emergency or safety purposes, mandatory reporting, oversight, or a valid legal process.

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If we create, maintain, or receive substance-use-disorder patient records protected by 42 C.F.R. Part 2, those records receive additional confidentiality protections. They generally may not be used or disclosed in a civil, criminal, administrative, or legislative investigation or proceeding against you without appropriate written consent or other authorization permitted by applicable law.

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Our Responsibilities

• We are required by law to maintain the privacy and security of your protected health information.

• We will notify you as required by law if a breach may have compromised the privacy or security of your information.

• We must follow the duties and privacy practices described in the notice currently in effect.

• We will not use or disclose your information in a way not described in this notice unless you authorize it in writing or the law permits or requires the use or disclosure.

• When a patient is a minor, we will determine privacy rights and access to information in accordance with applicable federal and Texas law.
   

Changes to This Notice

We may change this notice and apply the revised terms to all information we maintain. The current notice will be available on our website and upon request.

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Questions or Privacy Complaints

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TESSERA Psychiatry Privacy Officer

Name/Title: Lissa Garcia Segui, M.D., Privacy Officer
Email: contact@tesserapsychiatry.com

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You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, by mail at 200 Independence Avenue, S.W., Washington, D.C. 20201, by calling 1-877-696-6775, or through the HHS HIPAA complaint website.

TESSERA Psychiatry will not retaliate against you for filing a complaint or exercising your privacy rights.