On XX/XX/18 I requested Ms. XXXX XXXX to file a Dispute against XXXX XXXX for {$3700.00} after being forced to cancel treatment based on a Misleading quote ; Request for more money than agreed upon ; Undisclosed treatment spectrum ( reducing size of area to be treated for additional cost ) ; Additional cost for pain meds, all circumstances in violation of the Texas Deceptive Trade Practices Consumer Protection Act ( DTPA ) Paragraph 23 ; Services not rendered ; Cancellation 11 days prior to scheduled date ; Three ( 3 ) business days after signing Consent Form for XXXX XXXX to perform treatment : signature on XX/XX/18 and Notice of Cancellation on XX/XX/18 according to Texas Occupations Code Section 702.307 Cancellation of Contract for Full Refund known as right of rescission. The Original cost of treatment : {$11000.00} paid with Personal Visa XXXX {$4000.00} & Commercial Visa XXXX {$4000.00} and MC Debit Prosperity Bank {$3700.00}, all paid online on XX/XX/18 upfront as required before treatment ( XX/XX/18 ). Attached letters to XXXX & only transaction receipt sent unsecured by their Merchant eProcessing Network ; XXXX refused to provide Numbered, Official Paid Receipt billed for my records. On XX/XX/18 Ms. XXXX informed me via email that my Dispute claim on amount of {$3700.00} has been dismissed based on that I " apparently clicked something online before payment '' & also because of copy of a " Policy Form '' sent on XX/XX/18 by XXXX Merchant : XXXX XXXX, that I signed as a " Patient '' on XX/XX/18 -keep in mind that I have NOT authorized nor consented the Release of ANY Patient information Form signed to XXXX XXXX , having XXXX to release this " Patient Form '' to their unsecured, HIPAA noncompliance, Merchant and having this XXXX XXXX re-transmitted to Prosperity Bank , represents a clear violation of HIPAA Rights & PHI rules. Furthermore, this " Policy Form '' labeled " Payment, Refund And Replacement Policy '' clearly states above my signature as a " Patient '' that " I have read, understood and will adhere to the PAYMENT POLICY described above '', formally excluding my agreement from XXXX " Refund and Replacement '' policy segments. By law, for a " Patient '' to have read, understood and signed to adhere to XXXX Policy described on this document, it should have had read : " I have understood and will adhere to the PAYMENT, REFUND AND REPLACEMENT POLICY described above '' ; which is not the case. Please find attached letter sent by XXXX XXXX on XX/XX/18 responding to my claim through XXXX regarding the total return of {$11000.00} stating that she needed a signed Release of Information from me in order to address this issue. Apparently, XXXX XXXX 's office has NOT regards with HIPAA laws when electronically sending " Patient Forms '' to Merchants and Banks but, it is a problem when it comes to address this issue. In addition, Prosperity Bank has no problems in accepting documents not properly authorized by HIPAA laws as well. Since the Fraud Dept. has decided to close this dispute in 3 days according to Ms. XXXX 's email, I requested by certified mail that her office responds in writing regarding their Fraud Departments Policies, Procedures, Credentials, Limitations and Responsibilities but no answer as of to date, has been provided.