Patient Rights & Notices 

Brooklyn Psychotherapy is committed to protecting your privacy, treating everyone fairly, and being clear about costs. This page brings together the notices we are required to share, and the ways you can reach us with a question or concern.

Your privacy

Our Notice of Privacy Practices explains how we use and protect your health information, and your rights, including your right to see and get a copy of your records. Read the Notice of Privacy Practices (PDF).

You will also receive a copy when you begin treatment. Paper copies are available at both offices.

Privacy questions or complaints: contact our Compliance Officer using any of the options in “Report a concern” below. You can also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, at www.hhs.gov/ocr/complaints or 1-800-368-1019. We will never retaliate against you for filing a complaint.

Your right to a Good Faith Estimate

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.

Under the law, health care providers need to give patients who don’t have insurance, or who are not using insurance, an estimate of the bill for medical items and services.

  • You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.

  • Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.

  • If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

  • Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-800-985-3059.

If you pay for therapy yourself, including on our sliding scale, we give you a written estimate before your first session and at least once a year after that. Questions: billing@brooklynpsychotherapy.org or (347) 474-8464.

Insurance plans we participate in

We accept Medicaid Managed Care plans, ACA plans and many commercial plans. See the full list of plans we're in network with on our Insurance page.

Some plans are accepted only by certain clinicians, so please confirm with us before your first session. If a therapist is out of network with your plan, we will tell you in writing before your first session. 

Report a compliance or privacy concern

Anyone, including clients, family members, staff, and contractors, can ask a compliance question or report a concern about billing, documentation, privacy, fraud, or anything else that doesn’t seem right. You can do this anonymously. Reports go only to our Compliance Officer and are handled confidentially. Retaliation for good-faith reporting is prohibited.

  • Anonymous online form: Report a concern or ask a question

  • Confidential line: (347) 352-0494 (dial *67 first to hide your number)

  • Email: compliance@brooklynpsychotherapy.org

  • Mail: Compliance Officer (Confidential), Brooklyn Psychotherapy, 705 Manhattan Avenue, Brooklyn, NY 11222

You can also report directly to government agencies:

  • NY Office of the Medicaid Inspector General: 1-877-87-FRAUD (1-877-873-7283), omig.ny.gov

  • HHS Office of Inspector General: 1-800-HHS-TIPS (1-800-447-8477), tips.oig.hhs.gov

  • HHS Office for Civil Rights (privacy and civil rights): 1-800-368-1019, www.hhs.gov/ocr

This is not for appointments, billing questions, or emergencies. In an emergency, call 911. For a mental health crisis, call or text 988.

Nondiscrimination and free language help

Brooklyn Psychotherapy, LCSW, PC complies with applicable federal civil rights laws. We do not discriminate on the basis of race, color, national origin, age, disability, or sex. Under New York State and New York City law, we also do not discriminate on the basis of sexual orientation, gender identity or expression, religion, creed, marital status, or any other status those laws protect.

Free services: qualified interpreters, including sign language; information in other languages; large print, audio, and accessible electronic formats; and reasonable changes to our policies. To ask, call (347) 474-8464, email office@brooklynpsychotherapy.org, or tell your therapist.

If you believe we failed to provide these services or discriminated against you, you can file a grievance with our Section 1557 Coordinator by phone at (347) 352-0494, by email at compliance@brooklynpsychotherapy.org, through our online form, or by mail to 705 Manhattan Avenue, Brooklyn, NY 11222. The Coordinator can help you file it. You can also file a complaint with the HHS Office for Civil Rights at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf or 1-800-368-1019 (TDD 1-800-537-7697).

ATTENTION: If you speak a language other than English, free language assistance services are available to you. Appropriate auxiliary aids and services, to provide information in accessible formats, are also available free of charge. Call (347) 474-8464 or speak to your provider.

Español (Spanish): ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. También están disponibles de forma gratuita ayuda y servicios auxiliares apropiados para proporcionar información en formatos accesibles. Llame al (347) 474-8464 (TTY: 711) o hable con su proveedor.

简体中文 (Chinese, Simplified): 注意：如果您说中文，我们将免费为您提供语言协助服务。我们还免费提供适当的辅助工具和服务，以无障碍格式提供信息。致电 (347) 474-8464（文本电话：711）或咨询您的服务提供商。

繁體中文 (Chinese, Traditional): 注意：如果您說中文，我們可以為您提供免費語言協助服務。也可以免費提供適當的輔助工具與服務，以無障礙格式提供資訊。請致電 (347) 474-8464（TTY：711）或與您的提供者討論。

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Kreyòl Ayisyen (Haitian Creole): ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd aladispozisyon w gratis pou lang ou pale a. Èd ak sèvis siplemantè apwopriye pou bay enfòmasyon nan fòma aksesib yo disponib gratis tou. Rele nan (347) 474-8464 (TTY: 711) oswa pale avèk founisè w la.

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Français (French): ATTENTION : Si vous parlez Français, des services d'assistance linguistique gratuits sont à votre disposition. Des aides et services auxiliaires appropriés pour fournir des informations dans des formats accessibles sont également disponibles gratuitement. Appelez le (347) 474-8464 (TTY : 711) ou parlez à votre fournisseur.

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