Payment is due at time of session. Credit card or Zelle accepted. A card is required to be on file to secure the first session. All clinicians are considered an out-of-network providers for all insurance companies. Licensed clinicians can gladly provide a superbill monthly if you wish to seek reimbursement and utilize available out-of-network benefits. Please check with your insurance provider for more details and eligibility. Additionally, please note that a diagnosis must be provided should you wish to submit a superbill to your insurance provider. Clinicians do not communicate with insurance and reimbursement is not guaranteed.  Student interns cannot provide superbills at this time due to not being a licensed clinician; however, a receipt can be issued upon request. 

Brianne accepts Crime Victims Compensation as well as a Kristi's List Provider and Connect to Care voucher Provider through Nurtured TX

Current sliding scale availability:

2 sliding scale spots of $115 per 50 minute session available for those with financial hardship for bi-weekly scheduled sessions.  

1 sliding scale spots of $75 for those with financial hardship for weekly sessions. 

These spots are re-evaluated after 10 sessions and are not eligible for superbills.

FORMS

Please complete after your phone consultation

GOOD FAITH ESTIMATE

You have the right to receive a “Good Faith Estimate” explaining how much your medical and mental health 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 expected charges for medical services, including psychotherapy services. 

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency healthcare services, including psychotherapy services. 

You can ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule a 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. 

NOTICE: YOUR RIGHTS REGARDING HEALTH RECORDS AND COMPLAINTS

The staff at Austin Women's Counseling take this profession very seriously and strive to provide the highest quality of care to all clients. If you feel that you have been unprofessionally mistreated or experienced treatment beyond ethical bounds, please allow us to have a conversation with you about it so that we can explore a repair as well as how we can improve and provide the best quality care for other clients.

In accordance with Texas Health and Safety Code Sec. 181.105, this facility provides the following information regarding your access to protected health information and the process for filing complaints.

1. How to Request Your Health Care Records

You have the right to inspect or obtain a copy of your health records. To exercise this right, please follow these instructions:

• Written Request: Submit a formal request in writing to Brianne Blevins or Austin Women's Counseling.

• Submission Method: You may deliver your request via email to brianne@austinwomenscounseling.com

• Format: Please specify if you prefer a digital copy or a paper copy.

• Timeline: We will respond to your request within 15 business days of receipt, as required by Texas law.

• Fee: A fee may apply as permitted by law.

2. Contacting Regulatory Authorities

If you have questions or concerns regarding my professional conduct or licensing, you may contact the state regulatory board:

• Authority: Texas State Board of Examiners of Professional Counselors (under the Texas Behavioral Health Executive Council).

• Website: www.bhec.texas.gov

• Mailing Address: 1801 Congress Ave., Ste. 7.300, Austin, Texas 78701

• Phone: (512) 305-7700

TX LMFT license #201508

​TX LPC license #66304

FL LMFT license #TPMF1708

For more information on licensing verification in Texas, please click here.  For licensing information in Florida, please click here.

3. Filing a Consumer Complaint

If you believe your privacy rights have been violated or wish to file a complaint regarding the handling of your health records:

• Internal Complaint: Please first contact Brianne Blevins at brianne@austinwomenscounseling so we can attempt to resolve the issue immediately.

• HIPAA Privacy Violation Complaint: You may contact the U. S. Department of Health and Human Services, Office for Civil Rights, at: OCRMail@hhs.gov.

• State Complaint (Texas Attorney General): You may file a complaint with the Office of the Attorney General of Texas regarding violations of the Texas Medical Records Privacy Act.

• Website: www.texasattorneygeneral.gov

• Phone: (800) 621-0508