Privacy & Billing Practices

THIS NOTICE DESCRIBES HOW YOUR PROTECTED HEALTH INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.  PLEASE REVIEW IT CAREFULLY.

NOTICE OF PRIVACY PRACTICES

Effective February 16, 2026

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED, HOW YOU CAN GET ACCESS TO THIS INFORMATION, AND HOW TO FILE A PRIVACY COMPLAINT. PLEASE REVIEW IT CAREFULLY.

Your Information, Your Rights, and Our Responsibilities

This Notice applies to protected health information (PHI) maintained by Brighter Pathways, PLLC. PHI is information about your health, treatment, or payment for care that can identify you. Certain mental health and substance use disorder records may receive additional protection under federal or Illinois law.

I. How We Typically Use and Disclose Your Information

We may use and disclose your PHI for treatment, payment, and health care operations without your written authorization, as permitted by HIPAA and applicable state law. When Illinois law or another law provides greater protection, we will follow the more protective law.

Treatment. We may use your information and share it with professionals who are treating you to provide, coordinate, or manage your care. For example, with the permission required by applicable law, a therapist may consult with another treating provider.

Payment. We may use and disclose information to bill and obtain payment from health plans or other entities, determine eligibility or coverage, and conduct utilization review, as permitted by law.

Health care operations. We may use and disclose information to run our practice, improve care, conduct quality-assessment activities, manage cases, coordinate care, perform audits, obtain professional services, and conduct other permitted administrative activities.

II. Uses and Disclosures Requiring Written Authorization

We will obtain your written authorization before using or disclosing PHI for a purpose not described in this Notice, unless the use or disclosure is otherwise permitted or required by law. We will obtain written authorization for marketing purposes, for the sale of PHI, and for most uses and disclosures of psychotherapy notes, except where HIPAA permits otherwise.

Psychotherapy notes are notes recorded by a mental health professional documenting or analyzing the contents of a counseling session that are kept separate from the rest of the medical record. They do not include medication information, session times, treatment modalities and frequency, test results, summaries of diagnosis, functional status, treatment plan, symptoms, prognosis, or progress.

You may revoke an authorization in writing at any time. The revocation will not affect actions already taken in reliance on the authorization and may be subject to other limits allowed by law.

Special Protection for Substance Use Disorder Records

Brighter Pathways is not a Part 2 program, but we may receive or maintain substance use disorder patient records protected by 42 CFR Part 2 (Part 2). To the extent we maintain such records, we will protect them as required by Part 2, HIPAA, and applicable state law.

Part 2 records will not be used or disclosed in any civil, criminal, administrative, or legislative investigation or proceeding against you, and we will not provide testimony concerning those records, unless you provide written consent that specifically permits the use or disclosure or a court order meeting Part 2 requirements is accompanied by a subpoena or other legal mandate when required.

When Part 2 records are disclosed pursuant to a valid consent to a HIPAA-covered entity or business associate, the recipient may generally use and redisclose the information as HIPAA permits. Part 2 protections against use of the information in investigations or proceedings against you continue to apply.

If we use Part 2 information for fundraising communications, we will provide clear and conspicuous advance notice and a choice about whether to receive those communications. Brighter Pathways does not sell Part 2 records.

III. Other Uses and Disclosures Permitted or Required by Law

We may use or disclose PHI without your authorization when permitted or required by law. Conditions and limitations apply. Examples include:

·   Child abuse or neglect reporting and other reports required by law.

·   Reports concerning abuse, neglect, or exploitation of an adult protected by applicable law.

·   Health oversight activities authorized by law, including audits, inspections, licensure, and disciplinary matters.

·   Public health and safety activities, including preventing disease, product recalls, adverse-event reporting, and preventing or reducing a serious and imminent threat to health or safety.

·   Workers' compensation claims and similar programs authorized by law.

·   Certain law-enforcement, coroner, medical-examiner, funeral-director, military, national-security, and other specialized government functions.

·   Research when the requirements of applicable law have been met.

·   Disclosures to the U.S. Department of Health and Human Services to demonstrate our compliance with federal privacy law.

Family, friends, and others involved in your care. When permitted by law, you may tell us whether we may share relevant information with a family member, close friend, or other person involved in your care or payment for your care. If you cannot tell us your preference, we may share limited information when we reasonably believe doing so is in your best interest or is necessary to lessen a serious and imminent threat.

Disaster relief. When permitted by law, we may share limited information with a disaster-relief organization so that family or others responsible for your care can be notified about your location, condition, or death.

Judicial and administrative proceedings. Mental health records may be privileged and subject to protections under Illinois law. We will disclose information in response to legal process only as permitted or required by applicable law. The additional protections described above apply whenever the requested information includes Part 2 records.

IV. Your Privacy Rights

Get an electronic or paper copy of your record. You may ask to inspect or obtain an electronic or paper copy of PHI in the designated record set that we use to make decisions about you. This right generally does not include separately maintained psychotherapy notes or information compiled in reasonable anticipation of, or for use in, a civil, criminal, or administrative proceeding. We will ordinarily respond within 30 days and may take one additional 30-day extension when permitted by law and after giving you written notice. We may charge a reasonable, cost-based fee.

Ask us to correct your record. You may ask us to amend information you believe is incorrect or incomplete. We may deny the request, but we will explain the reason in writing. We will act within 60 days and may take one additional 30-day extension when permitted by law and after giving you written notice.

Request confidential communications. You may ask us to contact you in a particular way or at a different location. We will accommodate reasonable requests.

Contact and Message Preferences

Please identify the telephone number and email address Brighter Pathways may use to contact you. Select your permissions below. These preferences do not authorize disclosure of your clinical records, and you may change them by notifying us in writing.

Preferred telephone number: ____________________________________________________

May Brighter Pathways call this number?     [ ] Yes     [ ] No

May Brighter Pathways send text messages to this number?     [ ] Yes     [ ] No

If we reach voicemail, may we leave a message?     [ ] Yes     [ ] No

Preferred email address: _______________________________________________________

May Brighter Pathways contact me at this email address?     [ ] Yes     [ ] No

Ask us to limit what we use or disclose. You may ask us not to use or disclose certain information for treatment, payment, or health care operations. We are generally not required to agree. If we agree, we may still disclose information for emergency treatment or when otherwise required by law.

Restrict disclosures to a health plan after payment in full. If you pay out-of-pocket in full for a service or item, you may ask us not to disclose information about that service or item to your health plan for payment or health care operations. We will agree unless the disclosure is required by law.

Get an accounting of disclosures. You may ask for an accounting of certain disclosures made during the six years before your request. The accounting generally excludes disclosures for treatment, payment, and health care operations and certain other disclosures, including disclosures you authorized or asked us to make. One accounting in a 12-month period is free; we may charge a reasonable, cost-based fee for an additional accounting after informing you in advance.

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

Choose someone to act for you. If a person has legal authority to act on your behalf, such as a legal guardian, health care power of attorney, or another authorized personal representative, that person may exercise your privacy rights. We will verify the person's authority before taking action.

Complain without retaliation. You may complain if you believe your privacy rights have been violated. We will not retaliate against you for filing a complaint or exercising a privacy right.

V. Illinois Mental Health Confidentiality

Illinois law may provide additional protection for mental health and developmental-disability records, including limits on disclosure and legal process. We will not disclose mental health treatment records without written consent unless disclosure is permitted or required by Illinois or federal law. When Illinois law provides greater privacy protection than HIPAA, we will follow Illinois law.

VI. Our Responsibilities

·   We are required by law to maintain the privacy and security of your PHI and applicable Part 2 records.

·   We must follow the duties and privacy practices described in the Notice currently in effect and provide you with a copy.

·   We will notify you promptly as required by law if a breach occurs that may have compromised the privacy or security of your information.

·   We will not use or disclose your information other than as described in this Notice unless you authorize us in writing or the law otherwise permits or requires it. You may revoke an authorization in writing as described above.

VII. Questions and Complaints

For questions, additional information, or a complaint, contact:

Privacy Contact: Office Manager, Brighter Pathways, PLLC

Address: 605 Landwehr Road, Northbrook, Illinois 60062

Telephone: (224) 723-5772

Website: brighterpathways.net

You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, by writing to 200 Independence Avenue, S.W., Washington, D.C. 20201; calling 1-877-696-6775; or visiting hhs.gov/hipaa/filing-a-complaint. We will not retaliate against you for filing a complaint.

VIII. Changes to This Notice

We may change the terms of this Notice, and the changes may apply to all information we maintain, including information created or received before the change. The current Notice will be available upon request, in our office, and on our website. This Notice is effective February 16, 2026.

Surprise Billing Protection 

The No Surprises Billing Act aims to protect you from unexpected medical or healthcare bills. If  you choose to receive services from our practice, though we are out-of-network with your insurance, we will provide you will a form asking whether you would like to give up those protections and pay more for out-of-network care. We will also provide you with a good faith estimate for our services.

If we are out-of-network with your insurance, getting care from us could cost you more. 

If your plan covers the item or service you’re getting, federal law protects you from higher bills: 

·       When you get emergency care from out-of-network providers and facilities, or 

·       When an out-of-network provider treats you at an in-network hospital or ambulatory surgical center without your knowledge or consent. 

Ask your health care provider or patient advocate if you need help knowing if these protections apply to you. 

 If you sign the form, you may pay more because:
• You are giving up your protections under the law.
• You may owe the full costs billed for items and services received.
• Your health plan might not count any of the amount you pay towards your deductible and out-of-pocket limit. Contact your health plan for more information. 

You shouldn’t sign the form if you didn’t have a choice of providers when receiving care. For example, if a doctor was assigned to you with no opportunity to make a change. 

Before deciding whether to sign the form, you can contact your health plan to find an in-network provider or facility. If there isn’t one, your health plan might work out an agreement with this provider or facility, or another one. 

►Review your detailed estimate. We will provide you with a cost estimate for each item or service you’ll get. 

►Call your health plan. Your plan may have better information about how much you will be asked to pay. You also can ask about what’s covered under your plan and your provider options. 

►Questions about this notice and estimate? Call and speak with our patient assistant (224)723-5772.

►Questions about your rights? Contact No Surprises Help Desk at 1-800-985-3059.

Prior authorization or other care management limitations: 

Except in an emergency, your health plan may require prior authorization (or other limitations) for certain items and services. This means you may need your plan’s approval that it will cover an item or service before you get them. If prior authorization is required, ask your health plan about what information is necessary to get coverage.

 Understanding your options 

You can also get the items or services described in this notice from these providers who are in-network with your health plan: 

More information about your rights and protections 

Visit https://www.cms.gov/nosurprises/consumers for more information about your rights under federal law. 

IMPORTANT: You don’t have to sign this form. But if you don’t sign, this provider or facility might not treat you. You can choose to get care from a provider or facility in your health plan’s network. 

Good Faith Estimate For Health Care Items And Services Disclaimer(s):

·      Separate good faith estimates will be issued to an uninsured (or self-pay) individual upon scheduling or upon request of the items or services; an uninsured (or self-pay) individual can obtain good faith estimates for such items or services by contacting our patient assistant at (224)723-5772 or reception@brighterpathways.net.

·      This Good Faith Estimate shows the costs of items and services that are reasonably expected for your health care needs for an item or service. The estimate is based on information known at the time the estimate was created.

·      The Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment. You could be charged more if complications or special circumstances occur. If this happens, federal law allows you to dispute (appeal) the bill.

·      If you are billed for more than this Good Faith Estimate, you have the right to dispute the bill.

·      You may contact the health care provider or facility listed to let them know the billed charges are higher than the Good Faith Estimate. You can ask them to update the bill to match the Good Faith Estimate, ask to negotiate the bill, or ask if there is financial assistance available.

·      You may also start a dispute resolution process with the U.S. Department of Health and Human Services (HHS). If you choose to use the dispute resolution process, you must start the dispute process within 120 calendar days (about 4 months) of the date on the original bill.

·      There is a $25 fee to use the dispute process. If the agency reviewing your dispute agrees with you, you will have to pay the price on this Good Faith Estimate. If the agency disagrees with you and agrees with the health care provider or facility, you will have to pay the higher amount.

·      To learn more and get a form to start the process, go to www.cms.gov/nosurprises/consumers or call 1-800-985-3059.

·      For questions or more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises/consumers or call 1-800-985-3059.

·      This good faith estimate is not a contract and does not require the uninsured (or self-pay) individual to obtain the items or services from any of the providers or facilities identified in the good faith estimate.