Notices & Patient Rights
Thomas Psychological Services, PLLC is committed to protecting your privacy and ensuring you understand your rights as a client. The notices below explain how we handle your health information, your protections against discrimination, and your rights regarding billing. Paper copies of any notice are available upon request at our office.
Notice of Nondiscrimination & Language Assistance
Section 1557 of the Affordable Care Act
Thomas Psychological Services, PLLC complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin (including limited English proficiency and primary language), age, disability, or sex in the provision of psychological services.
Auxiliary Aids and Services: We provide appropriate auxiliary aids and services, free of charge, to people with disabilities to ensure effective communication, such as qualified interpreters and written information in other formats, upon request.
Language Assistance: We provide free language assistance services to people whose primary language is not English, such as qualified interpreters and information written in other languages, upon request.
ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 423-564-9084.
تنبيه: إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقم 9084-564-423.
Filing a Grievance: If you believe we have failed to provide these services or discriminated in another way, you may file a grievance with our Privacy Officer, Dr. Eva Thomas, PhD, at 447 Industrial Lane, Oneida, TN 37841, 423-564-9084. You may also file a civil rights complaint with the U.S. Department of Health & Human Services, Office for Civil Rights, at www.hhs.gov/ocr/complaints, or by phone at 1-800-368-1019.
NOTICE OF PRIVACY PRACTICES (HIPAA)
This Notice describes how your protected health information may be used and disclosed, and how you can access it. Effective Date: July 1, 2026.
How We May Use and Disclose Your Health Information: We may use and disclose your PHI without your written authorization for Treatment, Payment, Healthcare Operations, Business Associates (such as our EHR platform and testing software), and as Required by Law.
Mandatory Disclosures: We are required to disclose PHI in cases of imminent danger, mandatory reporting of abuse/neglect, duty to warn a credibly threatened third party, and court orders.
Your Rights: You have the right to inspect and copy your PHI, request amendments, request an accounting of disclosures, request restrictions, request confidential communications, receive a paper copy of this notice, and file a complaint with our practice or the HHS Office for Civil Rights (www.hhs.gov/ocr/privacy/hipaa/complaints, 1-877-696-6775) without penalty.
Assessment Reports: If you complete a psychological assessment with us, your evaluation report carries these same PHI protections. Release of your report requires your separate written Report Release Authorization.
Special Considerations for Minors: A parent or legal guardian generally has the right to access a minor's health information, subject to Tennessee-law exceptions and heightened protection for psychotherapy notes.
Contact: Dr. Eva Thomas, PhD, Privacy Officer, 447 Industrial Lane, Oneida, TN 37841, 423-564-9084, drevathomas@thomaspsychologicalservices.com
YOUR RIGHTS UNDER THE NO SURPRISES ACT
Right to Receive a Good Faith Estimate of Expected Charges
Under the law, health care providers must give patients who don't have certain types of health coverage, or aren't using their coverage, an estimate of the bill before services are provided.
Your Right to a Good Faith Estimate:
You have the right to receive a Good Faith Estimate for the total expected cost of any items or services, upon request or when scheduling.
If you schedule at least 3 business days in advance, you must receive the estimate in writing within 1 business day. If you schedule at least 10 business days in advance, you must receive it within 3 business days.
You can request an estimate before scheduling; it must be provided within 3 business days of your request.
If your bill is at least $400 more than your estimate, you can dispute the bill.
This right applies to uninsured and self-pay clients, including all clients receiving psychological assessment services, which are self-pay only.
For more information, visit www.cms.gov/nosurprises/consumers or call 1-800-985-3059.
Contact: Dr. Eva Thomas, PhD, Privacy Officer, 447 Industrial Lane, Oneida, TN 37841, 423-564-9084