Privacy Policy

Notice of Privacy Practices for Sentinel Mental Health Inc (SMH)

Effective Date: 7/28/25

This notice explains how medical information about you may be used and disclosed and how you can access this information. Please review it carefully.

At SMH, privacy is a top priority. Protecting the confidentiality of protected health information (PHI) is a commitment made in accordance with the Health Insurance Portability and Accountability Act (HIPAA) and applicable state laws.

Responsibilities

• The law requires maintaining the privacy and security of PHI.

• This Notice of Privacy Practices, describing legal duties and privacy practices regarding PHI, will be provided.

• Notification will be given following a breach of unsecured protected health information.

• The terms outlined in this notice must be followed.

How PHI may be used and disclosed

PHI may be used and disclosed for treatment, payment, and healthcare operations without written authorization.

• Treatment: To provide and coordinate healthcare and related services. This includes sharing information with other healthcare providers involved in treatment, with consent.

• Payment: To obtain payment for services, such as submitting claims to an insurance company.

• Healthcare Operations: For quality improvement activities, training, and business management of the practice.

Permitted uses and disclosures without authorization

PHI may also be used or disclosed without authorization under specific circumstances as permitted or required by law, such as:

• For public health activities, such as reporting diseases or vital statistics.

• For victims of abuse, neglect, or domestic violence, as required or permitted by law.

• For health oversight activities, such as audits and investigations.

• For judicial and administrative proceedings, such as in response to a court order or subpoena.

• For law enforcement purposes, such as to report certain crimes or identify a suspect.

• To coroners, medical examiners, and funeral directors.

• To facilitate organ, eye, or tissue donation.

• For research purposes, if certain conditions are met and the remuneration received is limited to reasonable cost-based fees to cover the cost to prepare and transmit the PHI.

• To avert a serious threat to health or safety.

• For specialized government functions, such as military and veterans activities.

• For workers' compensation purposes.

Uses and disclosures requiring authorization

• Written authorization will be obtained for any use or disclosure of PHI not otherwise permitted or required by law, such as most uses and disclosures of psychotherapy notes.

• Written authorization will be obtained for using or disclosing PHI for marketing purposes.

• Written authorization will be obtained for uses and disclosures that involve the sale of PHI.

• Authorization can be revoked at any time, except to the extent that action has already been taken in reliance upon it.

Rights regarding PHI

You have the following rights concerning your PHI:

• Right to Access: You can request to inspect and receive a copy of your PHI.

• Right to Amend: You can request that PHI be amended if it is believed to be inaccurate or incomplete.

• Right to an Accounting of Disclosures: You have the right to receive an accounting of certain disclosures of PHI made.

• Right to Request Restrictions: You can request restrictions on how PHI is used or disclosed for treatment, payment, or healthcare operations, or to individuals involved in care. There is no requirement to agree to the request, but if the request is agreed to, it will be followed.

• Right to Request Confidential Communications: You can request to receive communications about health information in a specific way or at a specific location.

• Right to a Paper Copy of This Notice: You can request a paper copy of this Notice of Privacy Practices at any time.

• Right to Complain: If you believe your privacy rights have been violated, a complaint can be filed with the practice or with the Department of Health and Human Services.

Commitment to not selling information

There is a commitment not to sell any Protected Health Information (PHI) to third parties without specific, written authorization.

Changes to this notice

The right is reserved to change the terms of this notice at any time, and the revised notice will be effective for all PHI maintained. A copy of the current notice will be available in the office and on the website.

Contact information

If you have any questions about this Notice of Privacy Practices or your rights, please contact:

Michael Eaton

1645 Ave D, Ste C

(406) 591-2199

Sentinelmentalhealthllc@gmail.com

Acknowledgement of receipt (optional but recommended)

• You may be asked to sign an acknowledgment of receipt of this Notice. This is to confirm that you have received this document, not that you have agreed to share your PHI in ways not permitted by law.

Disclaimer

• This template is a starting point and should be reviewed by legal counsel to ensure it meets all applicable HIPAA and state law requirements for your specific practice.

• It's crucial to consult with a legal professional to ensure full compliance with all relevant regulations.

Note: The information provided here is for general guidance and should not be considered legal advice. Consulting with a qualified legal professional specializing in healthcare law is essential to create a privacy policy tailored to your practice's specific needs and to ensure compliance with all applicable regulations.