Medical & Legal
Considered Care Integrative Health
Dr. Nayab Syed
This page contains information about patient privacy, access to care, healthcare cost estimates, and complaint procedures.
Practice contact: [Practice phone number]
Email: [Practice contact email]
Address: [Practice mailing address]
We respect the privacy of your protected health information.
Our complete Notice of Privacy Practices explains how we may use and disclose your medical information, our responsibilities for protecting it, and your rights concerning your records.
These rights include requesting access to your records, requesting corrections, asking for confidential communications, requesting certain restrictions, and receiving an accounting of certain disclosures.
You may request a paper copy of our Notice of Privacy Practices, even if you previously received it electronically.
If you have questions or believe your privacy rights have been violated, contact:
1. HIPAA Notice of Privacy Practices
Privacy contact: [Name or title]
Phone: [Privacy contact phone number]
Email: [Privacy contact email]
Mailing address: [Practice mailing address]
You may also submit a privacy complaint to the U.S. Department of Health and Human Services Office for Civil Rights:
https://www.hhs.gov/hipaa/filing-a-complaint/index.html
We will not retaliate against you for submitting a complaint.
Read or download our complete Notice of Privacy Practices:
[Insert link to the doctor-approved complete HIPAA Notice]
Notice effective date: [Effective date]
2. Nondiscrimination & Language Assistance
Considered Care Integrative Health complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.
We provide reasonable modifications and appropriate auxiliary aids and services for people with disabilities when needed for effective communication and equal access to care. These may include qualified interpreters and information in accessible formats.
We also provide language assistance for people with limited English proficiency, including qualified interpreters and translated information when needed. These services are provided free of charge.
To request language assistance, communication support, an accessible format, or a reasonable modification, contact:
Patient assistance contact: [Name or title]
Phone: [Practice phone number]
Email: [Practice contact email]
TTY or relay access: [Confirmed access method]
If you believe you have experienced discrimination or were denied appropriate assistance, contact the practice using the details above.
Civil rights coordinator, if applicable: [Name and contact details]
Grievance procedure, if applicable: [Link to approved procedure]
You may also file a civil rights complaint with the U.S. Department of Health and Human Services Office for Civil Rights:
https://www.hhs.gov/civil-rights/filing-a-complaint/index.html
Notice of Available Assistance
Free language assistance and appropriate communication aids are available. Please contact [Practice phone number] to request assistance.
[Insert the approved Notice of Availability in the required 15 languages for Texas, and any additional states in which the practice operates.]
3. Good Faith Estimate
Your Right to Receive an Estimate of Healthcare Costs
If you do not have health insurance, or you are not using insurance to pay for your care, you may receive a written Good Faith Estimate of expected charges for healthcare items and services.
You can request an estimate before scheduling care.
If you schedule care 3–9 business days in advance, the estimate should be provided within 1 business day after scheduling.
If you schedule care at least 10 business days in advance, the estimate should be provided within 3 business days after scheduling.
If you request an estimate before scheduling, it should be provided within 3 business days of your request.
The estimate explains expected charges for your scheduled care. Ask other providers involved in your care about their expected charges.
If a provider’s bill is at least $400 above that provider’s estimate, you may be eligible to dispute it through the federal patient-provider dispute resolution process.
Keep your estimate and billing documents.
To request an estimate: [Practice phone number or email]
For information about your rights, visit:
https://www.cms.gov/nosurprises/consumers
Or call 1-800-985-3059.
4. Texas Medical Board Complaint Information
Notice Concerning Complaints
Patients may report complaints concerning physicians or other professionals regulated by the Texas Medical Board to the Board for investigation.
Texas Medical Board Attention: Investigations
1801 Congress Avenue, Suite 9.200
P.O. Box 2018
Austin, Texas 78768-2018
Complaint assistance: 1-800-201-9353
Website: https://www.tmb.texas.gov/
Official English and Spanish complaint notice:
https://www.tmb.texas.gov/file/complaint-notice-poster
Información sobre quejas
Puede presentar una queja sobre un médico u otro profesional regulado por la Junta Médica de Texas.
Para obtener ayuda, llame al 1-800-201-9353.
Consulte el aviso oficial en inglés y español:
5. Texas Electronic Disclosure Notice
Considered Care Integrative Health may disclose your protected health information electronically.
Electronic disclosures may occur for treatment, payment, healthcare operations, or other purposes permitted or required by applicable state or federal law.
When a separate authorization is required, we will obtain authorization from you or your legally authorized representative before making the electronic disclosure.
Posting this notice does not itself constitute your authorization to disclose information.
To ask questions about electronic disclosures or applicable authorization procedures, contact:
Privacy contact: [Name or title]
Phone: [Privacy contact phone number]
Email: office@consideredcare.health