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HIPAA notice

HIPAA NOTICE OF PRIVACY PRACTICES

Mental Root

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Contact Information

For questions about this Notice, please contact:

Privacy Officer – Mental Root
Email: contact@mentalroot.com
Website: mentalroot.com

Effective Date

This Notice of Privacy Practices is effective as of: 9/5/2023

NOTICE SUMMARY

Your Rights

You have the right to:

  • Request a copy of your health records

  • Ask us to correct inaccurate health information

  • Request confidential communications

  • Ask us to limit what information we share

  • Receive a list of certain disclosures of your information

  • Obtain a copy of this Notice at any time

  • Appoint someone to act on your behalf

  • File a complaint if you believe your privacy rights have been violated

Your Choices

You may have choices regarding how we share information when we:

  • Communicate with family or others involved in your care

  • Respond to emergencies or disaster relief situations

  • Use information for marketing purposes (only with written permission)

Our Uses and Disclosures

We may use or share your health information to:

  • Support your treatment and care coordination

  • Operate and improve our healthcare services

  • Process payments and billing

  • Comply with legal requirements

  • Support public health and safety activities

  • Respond to law enforcement or court orders

  • Conduct approved health research

YOUR RIGHTS

1. Access Your Health Records

You may request to review or obtain a copy of your medical or billing records.

  • Requests must be made in writing to the Privacy Officer

  • We typically respond within 30 days

  • A reasonable cost-based fee may apply

2. Request Corrections

If you believe information in your record is incorrect or incomplete, you may request a correction.

  • We may deny certain requests, but we will explain why in writing within 60 days

3. Request Confidential Communication

You may request that we contact you in a specific way, such as:

  • Only by phone

  • Only at work

  • Through a different mailing address

We will honor reasonable requests, especially if disclosure could put you at risk.

4. Request Limits on Use or Disclosure

You may ask us not to use or share certain information for:

  • Treatment

  • Payment

  • Healthcare operations

We are not always required to agree, especially if it could impact your care.

5. Request an Accounting of Disclosures

You may request a list of certain disclosures made within the past six (6) years.

  • One request per year is free

  • Additional requests may incur a reasonable fee

6. Obtain a Paper Copy of This Notice

You may request a printed copy of this Notice at any time, even if you agreed to receive it electronically.

7. Choose Someone to Act for You

If you have:

  • A legal guardian

  • Medical power of attorney

That person may exercise your rights after proper verification.

8. File a Complaint

If you believe your privacy rights have been violated, you may file a complaint with Mental Root or with the U.S. Department of Health and Human Services:

Office for Civil Rights (OCR)
200 Independence Avenue, S.W.
Washington, D.C. 20201
Phone: 1-877-696-6775
Website: www.hhs.gov

Mental Root will not retaliate against you for filing a complaint.

YOUR CHOICES

In certain situations, you may direct us whether to share information with:

  • Family members

  • Close friends involved in your care

  • Individuals helping with payment

If you are unable to express your preference, we may share information if it is in your best interest or necessary to prevent serious harm.

We Never Share Without Written Permission For:

  • Marketing purposes

  • Sale of your health information

You may revoke written permission at any time.

OUR USES AND DISCLOSURES

Treatment

We may share your health information with healthcare professionals involved in your care.

Example: A provider shares information to coordinate treatment.

Healthcare Operations

We may use information to improve services, manage operations, and ensure quality care.

Example: Reviewing records to improve patient support programs.

Payment

We may use and disclose information to bill and collect payment for services.

Example: Submitting claims or verifying insurance coverage.

OTHER PERMITTED DISCLOSURES

We may share information without your permission when required or allowed by law, including:

  • Public health reporting

  • Preventing serious threats to safety

  • Research (with legal safeguards)

  • Organ donation coordination

  • Coroners or funeral directors

  • Workers’ compensation claims

  • Law enforcement and national security matters

  • Court orders, subpoenas, or legal proceedings

OUR RESPONSIBILITIES

Mental Root is required by law to:

  • Maintain the privacy and security of your protected health information (PHI)

  • Notify you promptly if a breach occurs

  • Follow the privacy practices described in this Notice

  • Provide you with a copy of this Notice

  • Not use or disclose information outside these Terms without your written authorization

CHANGES TO THIS NOTICE

Mental Root may update this Notice at any time. Updates apply to all PHI we maintain. The current version will always be available upon request and on our Website.

FOR MORE INFORMATION

To learn more, contact our Privacy Officer or visit: