NOTICE OF PRIVACY PRACTICES
(Sinat NP for Mental Wellness)
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
At Sinat NP for Mental Wellness (“the Practice”), we are committed to protecting your privacy. As required by federal law, we maintain the privacy of your Protected Health Information (“PHI”), which is information that identifies you or could be used to identify you. This Notice of Privacy Practices (“Notice”) explains our legal duties, privacy practices, and your rights regarding your PHI that we collect and maintain.
YOUR RIGHTS
You have several rights regarding your PHI, described below. To exercise these rights, please submit a written request to the Practice at the address provided at the end of this Notice.
Inspect and copy your PHI
You can request an electronic or paper copy of your medical record or other PHI. The Practice may charge a reasonable fee for copies.
We may deny your request if we believe that releasing the information could endanger your life or someone else’s. You may have the right to have this denial reviewed.
Amend your PHI
You can ask to correct PHI you believe is inaccurate or incomplete. We may require your request in writing and ask for a reason.
We may deny your request. If denied, you’ll receive a written explanation and the right to submit a written statement of disagreement.
Request confidential communications
You can ask the Practice to contact you in a specific way (for example, by mail or at a different phone number). We will accommodate reasonable requests.
Limit what we use or share
You can ask the Practice not to use or share PHI for treatment, payment, or business operations. While we will consider your request, we are not required to agree if it could affect your care.
If you pay for a service or healthcare item entirely out-of-pocket, you can request that we not share that information with your health insurer.
You may request that we not share your PHI with specific individuals, such as family members or friends, by providing details of the requested restriction.
Obtain a list of disclosures
You can request an “accounting” of certain disclosures of your PHI. You are entitled to one free accounting every 12 months; additional requests may incur a reasonable fee.
Receive a copy of this Notice
You can request a paper copy of this Notice at any time, even if you agreed to receive it electronically.
Choose someone to act for you
If you have given someone medical power of attorney or someone is your legal guardian, that person may exercise your rights regarding your PHI.
File a complaint if you feel your rights are violated
You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights:
Address: 200 Independence Avenue, S.W., Washington, D.C. 20201
Phone: 1-877-696-6775
The Practice will not retaliate against you for filing a complaint.
Opt out of fundraising communications
The Practice may contact you for fundraising efforts. You can request not to be contacted again.
OUR USES AND DISCLOSURES
1. Routine uses and disclosures of PHI
We may use and share your PHI without your written authorization for activities related to treatment, payment, and healthcare operations. For example:
Treatment:
We may use or share your PHI with other healthcare providers involved in your care.
Example: Your primary care physician may request updates about your psychiatric treatment.
Healthcare operations:
We may use and share PHI to manage our practice, improve your care, and contact you as needed.
Example: We may use PHI to send you appointment reminders if you choose.
Payment:
We may use and share PHI to bill for your services and obtain payment from insurers or other payers.
Example: We may provide information to your insurance company for payment of services.
2. Uses and disclosures of PHI that may occur without your authorization or opportunity to object
We may use or disclose PHI without your authorization in circumstances including, but not limited to:
Public health and safety:
Reporting diseases, injuries, or vital events like births and deaths.
Reporting adverse medication reactions or product recalls.
Health oversight:
For audits, investigations, and inspections by government agencies overseeing healthcare systems, government programs, or civil rights compliance.
Required by the Secretary of Health and Human Services:
To ensure compliance with HIPAA regulations.
To prevent a serious threat to health or safety.
Abuse or neglect:
Reporting suspected abuse, neglect, or domestic violence.
Legal and governmental purposes:
As required by federal, state, or local law.
For judicial or administrative proceedings in response to a court order or subpoena.
For law enforcement purposes, such as locating missing persons or reporting certain crimes.
For military or national security activities.
To comply with workers’ compensation laws.
Other situations:
To coroners, medical examiners, or funeral directors for lawful duties.
For organ and tissue donation purposes.
For approved research under strict privacy safeguards.
In correctional settings if you are incarcerated.
To business associates performing services on our behalf who have agreed to protect your information.
3. Uses and disclosures of PHI that may be made with your authorization or opportunity to object
Unless you object, we may disclose PHI:
To family, friends, or others involved in your care if the PHI directly relates to that person’s involvement.
If it is in your best interest and you are unable to state your preference.
4. Uses and disclosures of PHI based upon your written authorization
We must obtain your written authorization before using or disclosing your PHI for:
Marketing purposes
Sale of PHI
Use or disclosure of psychotherapy notes (where applicable)
You may revoke your authorization at any time by submitting a written request to us. We will not use or share your PHI for purposes not described in this Notice unless you give written permission.
OUR RESPONSIBILITIES
The Practice is required by law to maintain the privacy and security of your PHI.
We must follow the terms of this Notice currently in effect. Where federal or state laws provide more protection, we will follow the stricter law.
We reserve the right to change this Notice. Changes apply to all PHI we maintain. You can always request a copy of the latest Notice
We will inform you promptly if a breach occurs that compromises your PHI.
This Notice is effective as of July 3rd, 2025.