Notice of Privacy Practices

Effective Date: May 20, 2025

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

At Stillwater Health, we are deeply committed to protecting your privacy. This Notice of Privacy Practices (“Notice”) explains how we use, share, and safeguard your protected health information (PHI) in compliance with the Health Insurance Portability and Accountability Act (HIPAA) and other applicable laws. It also outlines your rights and the steps you can take to control how your information is handled.

This Notice applies to all staff, clinicians, and business associates working on behalf of Stillwater Health at our facility located at:

Stillwater Health

4570 Pecan Drive, Suite C

Paducah, KY 42001

Phone: (270) 908-3839

Email: info@stillwaterhealthky.com

Website: www.stillwaterhealthky.com

We will provide this Notice to all patients upon their first appointment. It is also available at our office and on our website. We will ask you to acknowledge receipt of this Notice, and if you choose not to sign, we will note that it was provided.

Our Legal Responsibilities

Stillwater Health is legally required to:

Maintain the privacy and security of your PHI
Provide you with this detailed Notice of our legal duties and privacy practices
Follow the terms of this Notice
Notify you promptly if a breach occurs that may have compromised your information

How We May Use and Disclose Your Health Information

1. For Treatment

We may use and share your PHI to coordinate, manage, and deliver the care and services you receive — including with doctors, nurses, therapists, pharmacies, and other providers involved in your treatment. This may include services like:

Ketamine-assisted therapy
Transcranial Magnetic Stimulation (TMS)
BrainsWay Deep TMS
Spravato® (esketamine) treatment
Medication management
Psychiatric evaluation and psychotherapy

We may also contact you via phone, email, or text with appointment reminders and information related to your care.

2. For Payment

We may use or disclose your PHI to bill and collect payment for the services we provide. This includes sharing necessary information with your insurance company, Medicare, Medicaid, or any third-party payer to:

Verify benefits and eligibility
Obtain prior authorization
Submit claims
Coordinate benefits
Collect unpaid balances (when necessary, with minimal disclosure to collection services)

3. For Healthcare Operations

We may use or disclose your PHI as part of our healthcare operations to improve quality of care and manage our practice. This includes:

Internal audits and quality improvement initiatives
Staff training and supervision
Accreditation, licensing, and credentialing
Billing and accounting
Third-party service providers under HIPAA-compliant business associate agreements (e.g., billing systems, software vendors)

Other Uses and Disclosures Allowed or Required by Law

We may use or share your PHI without your written authorization under the following circumstances:

Emergencies & Family Involvement

We may disclose your PHI to a family member, friend, or caregiver who is involved in your care, especially in emergencies or if you are unable to consent.

As Required by Law

We may disclose your PHI when required by federal, state, or local law.

Public Health & Safety

We may share information with public health authorities to help:

Prevent or control disease, injury, or disability
Report abuse, neglect, or domestic violence
Prevent serious threats to health or safety

Health Oversight

We may disclose your PHI to health oversight agencies for activities such as audits, investigations, inspections, licensure, or disciplinary actions.

Judicial & Administrative Proceedings

We may disclose your PHI under a valid subpoena, court order, or other lawful request.

Law Enforcement

We may share PHI with law enforcement to report crimes on our premises, identify or locate a suspect, or respond to a serious threat.

Special Government Functions

If you are in the military or involved with national security, your PHI may be disclosed to authorized officials under specific conditions.

Worker’s Compensation

We may share your PHI with employers or insurance providers to evaluate or manage work-related injuries or illnesses.

Medical Emergencies

In life-threatening emergencies, we may share necessary PHI to ensure you receive proper treatment.

Deceased Individuals

We may disclose limited PHI to family or legal representatives after your death, as required by law. PHI of individuals deceased for over 50 years is no longer protected under HIPAA.

Uses and Disclosures That Require Your Written Authorization

We will obtain your written authorization before using or disclosing your PHI for any purpose not specifically listed above. This includes:

Marketing communications not related to your treatment
Sharing your information with third parties for legal or insurance purposes
Sale of your PHI
Disclosure of highly confidential information including:

Mental health and psychotherapy notes
Substance use disorder treatment
HIV/AIDS status
Genetic testing
Sexual assault or abuse records

You may revoke your authorization in writing at any time, except where we’ve already acted on it.

Your Rights Regarding Your Health Information

1. Right to Access and Copy

You have the right to view and request copies of your medical and billing records. Requests must be in writing. A reasonable fee may apply for copies.

2. Right to Amend

If you believe any information in your records is inaccurate or incomplete, you can request a written amendment. While we may deny your request, we’ll notify you in writing with an explanation.

3. Right to Confidential Communications

You can request that we communicate with you through specific methods or locations (e.g., via email or only at work). We will honor all reasonable requests.

4. Right to an Accounting of Disclosures

You may request a list of certain disclosures we made of your PHI, other than those for treatment, payment, or healthcare operations. A fee may apply for multiple requests in a 12-month period.

5. Right to Restrict Use or Disclosure

You can request restrictions on how we use or share your PHI. While we’re not required to agree to all restrictions, we will comply with any that are legally required.

6. Right to a Paper Copy

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

Changes to This Notice

We reserve the right to revise this Notice at any time. The new Notice will apply to all PHI we maintain and will be posted prominently in our office and on our website.

Questions or Complaints

If you believe your privacy rights have been violated, or if you have questions about this Notice, you may contact:

Privacy Officer

Stillwater Health