Notice of Privacy Practices for Protected Health Information

Introduction

Mantality Health is committed to protecting the privacy and security of your personal health information (PHI) in compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA). This document explains your rights regarding your PHI, how we may use and disclose it, and our obligations to protect it.

Your Rights

As a patient, you have the right to:

Access Your Information: Request to view or obtain a copy of your health records.
Request Corrections: Ask for corrections to your health records if you believe there is an error.
Receive Confidential Communications: Request communication in a specific way (e.g., via email or at an alternative address).
Request Restrictions: Limit how your PHI is used or disclosed.
Obtain a List of Disclosures: Receive an accounting of certain disclosures of your PHI.
File a Complaint: Complain if you believe your rights have been violated.

How Mantality Health May Use and Disclose Your PHI

Treatment: Share your information with healthcare providers to coordinate your care.
Payment: Use your PHI to bill and collect payment for services rendered.
Healthcare Operations: Use your PHI for internal operations, such as quality improvement and staff training.
As Required by Law: Disclose your PHI when required by federal, state, or local laws.

We will not use or disclose your information for marketing purposes, sell your PHI, or share your information without your explicit consent unless otherwise allowed by law.

SMS Communication

Text messaging originator opt-in data and consent will not be shared with any third parties, excluding aggregators and providers of the Text Message services. We do not sell or release any data shared with us.

Mantality Health’s Responsibilities

We are required by law to:

Maintain the privacy and security of your PHI.
Provide you with this Notice of Privacy Practices.
Notify you promptly if a breach compromises the privacy or security of your information.
Follow the terms of this Notice and not use or disclose your information in ways not described here.

Changes to This Notice

Mantality Health reserves the right to change this Notice at any time. Any changes will apply to all PHI we maintain. The revised Notice will be available upon request, in our offices, and on our website.

How to Exercise Your Rights

For questions about this Notice or to exercise your rights, please contact:

Mantality Health
18118 Chesterfield Airport Rd, Unit G, Chesterfield, MO 63005
615-263-9298
info@mantalityhealth.com

Filing a Complaint

If you believe your privacy rights have been violated, you may file a complaint with:

Mantality Health Privacy Officer
David Jansen – dave@mantalityhealth.com

Or with:
U.S. Department of Health and Human Services Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
1-800-368-1019

You will not be penalized for filing a complaint.

Effective Date

This Notice is effective as of December 1, 2024.

Green Bay, WI

Created by potrace 1.16, written by Peter Selinger 2001-2019 W5361 County Rd KK, Suite A, Appleton, WI 54915

W5361 County Rd KK, Suite A, Appleton, WI 54915