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1. More privacy. When you self-pay, Client notes are not shared with an insurance company.

2. More flexibility over your care. Insurance requires a diagnosis within the first session. With self-pay, you do not need a diagnosis to receive services.

3. No session limits. Insurance requires predominantly 53-minute sessions. For some, your EAP or insurance may only pay for a fixed amount of sessions. We do not worry about this with private pay! You have the freedom to decide when we are done.

4. Fewer barriers to care. As a Clinician, I can use my entire skillset, not just the therapies that insurance will pay for. This also allows me to provide sliding scale options to those who qualify. Group session with Cerasee & Cocoa Tea Therapy are about 2 hours an individual sessions run for 90 minutes.

5. Consistent care! No more waiting for insurance to make the decisions. No more disrupting the continuity of care by insurance claim denials, late payments, or sporadic changes in policy.

6. We eventually will take insurance as we grow. As a fledgling 501(c)3 nonprofit, we are funded by donations and grants.

 Please follow the steps below:

Submit a written request. Choose one of the following options:

1. Via Patient Portal Complete our HIPAA-compliant Authorization form and submit it through the patient portal of Cerasee & Cocoa Tea Counseling, our electronic health records system.

Subject line: “REQUEST FOR RECORDS” Include: The specific records you are requesting, The name, address, and/or email address of the intended recipient Via Email (if you do not have portal access), 

OR

2. Email your written request and completed Authorization form to: CCTinfo@protonmail.com

Subject line: “REQUEST FOR RECORDS”

To help prevent delays, please include the following information with your request:

• Client full legal name and date of birth

• Current phone number and or email address

• Description of records requested including specific dates if applicable

• Preferred method of delivery such as secure electronic delivery, mail, or in person pickup

• Client signature and date

Additional requirements (if applicable): Litigation-related records If records are requested for use in litigation, please include: Cause number, Case title, & Court where the case is pending.

Business Records Affidavit: If you require a Business Records Affidavit, indicate this in your request Fee: $15 Affidavits will not be provided until payment is received.

Records fee: Fee for providing records: $25 for electronic records Accepted payment methods: Credit Cards or electronic payment (Zelle, Venmo, etc.).  Texas law does not require records to be released until fees are paid.

Couples, family, or third-party records If you are requesting: Couples counseling records, Family counseling records, Records for anyone other than yourself or your child State and federal law require either: A valid Court Order, or An Authorization signed by the individual (or parent/legal guardian) Relevant law: 45 C.F.R. §164.512(e); Texas Health & Safety Code §§611.004, 611.0045, 611.008 Instructions for Attorneys and Document Companies.

A subpoena alone is not sufficient to compel disclosure of confidential counseling or billing records, or other Protected Health Information (PHI), under HIPAA (45 C.F.R. Chapter 164). For mental health or medical records requested or subpoenaed in litigation (including testimony), HIPAA permits disclosure only under the following circumstances: In response to a valid court or administrative tribunal order, or When the individual (or parent/legal guardian): Is a party to the proceeding Has notice that the PHI has been requested Does not object to the disclosure.

An Authorization from the individual or parent satisfies this requirement. Relevant law: 45 C.F.R. §164.512(e).

Important Note If the client or parent has indicated that they do not consent to release of records: A “Statement of Assurance” will not be accepted.

A valid Authorization or Court Order will be required.

Adults.

I will see children only with their parent/guardian when participating in Group EMDR. This nonprofit values collective healing.

We are here for Caregivers. That includes but is not limited to:

• a Caregiver pre/post loss
• Autism Caregivers (you have a family member with special needs)
• Military Spouses and Children
• First Responders and their families
• Veteran groups
• Churches
• Hospice staff

At this time, I am NOT equipped to treat:

• unmanaged personality disorders
• those unwilling to try something new. Everything offered in this practice has a somatic (body) component. If you would prefer to vent and not practice any skills outside of sessions, it is best that you seek help elsewhere.

Cerasee & Cocoa Tea Therapy

Ayana Brown, Licensed Professional Counselor Associate, Supervised by Stuart Young, LPC Supervisor in the State of Texas #15351

In accordance with House Bill 4224 and Texas Health and Safety Code Section 181.105, Cerasee & Cocoa Tea Therapy provides the following information to assist clients and members of the public with:

• Requesting access to health care records
• Contacting the state licensing authority
• Filing a consumer complaint

How to Request Your Health Care Records

Current and former clients may request copies of their counseling and mental health records maintained by Cerasee & Cocoa Tea Counseling.

Requests must be submitted using the Records Request Form available at the following link: www.cctea.janeapp.com.

Requests may be submitted using one of the following methods:

Email preferred cctinfo@protonmail.com

Mail 5900 Balcones Dr Suite 29105 Austin, TX 78731

In person By appointment only

Office phone 2105711228

To help prevent delays, please include the following information with your request: • Client full legal name and date of birth • Current phone number and or email address • Description of records requested including specific dates if applicable • Preferred method of delivery such as secure electronic delivery, mail, or in person pickup • Client signature and date

If records are requested on behalf of another individual, documentation verifying legal authority is required. Examples include guardianship documentation or medical power of attorney.

Identity verification may be required to protect client privacy and confidentiality in accordance with applicable state and federal laws.

Licensing Authority Information

Cerasee & Cocoa Tea Therapy is regulated by the Texas Behavioral Health Executive Council, the licensing authority for Licensed Professional Counselors in the State of Texas.

Questions regarding licensure or professional regulation may be submitted through the Council’s website: https://bhec.texas.gov/contact-us/

When submitting an inquiry, select Licensed Professional Counselor as the license type.

Filing a Consumer Complaint

Clients or members of the public who wish to file a consumer complaint may do so through the Texas Office of the Attorney General Consumer Protection Division.

Complaints may be submitted online at: https://www.texasattorneygeneral.gov/consumer-protection/file-consumer-complaint

When submitting a complaint, include relevant dates, names, and any supporting documentation if available.

Questions Regarding House Bill 4224

For questions related to House Bill 4224 or consumer access requirements under Texas law, Texas Health and Human Services may be contacted at: HCR_PRU@hhs.texas.gov  

No.

You might be a good fit for Group EMDR if you are:

A Veteran, spouse, or adult child of a service member whose trauma symptoms are getting in the way of sleep, relationships, or work.

An adult child caring for elders while also carrying old trauma, and you need focused time to work on you, rather than everyone else.

A small group of Caregivers, families, retreats, couples, a Mom & son (Dad & daughter, etc.), foster families, or friends after a conflict.

Someone who wants to heal but doesn't want people to know the details or hear triggering stories from others.

Able to tolerate being in a small group while still doing your own internal work, even if you’re nervous at first.

Group EMDR is not appropriate for unmanaged personality disorders or active psychosis; if that’s you, we will offer an extra grounding session before processing trauma or help you connect with a higher level of care that fits your needs.

A unique aspect of this protocol is that participants will not share the specifics of their painful experiences. Instead, the focus will be on processing their upsetting emotions without sharing the distressing details. Participants will have the option to share positive experiences.