Notice of Privacy Practices

This Notice of Privacy Practices describes how medical and mental health information about you may be used and disclosed, and how you can get access to this information. For the purposes of the Health Insurance Portability and Accountability Act (HIPAA), Affiliates in Counseling, located in Northbrook, Illinois, is the covered entity responsible for protecting your health information. Rebecca Sheinman, LCSW, provides clinical services in affiliation with Affiliates in Counseling.

Please review this notice carefully. If you have any questions about it, you are welcome to reach out before your first appointment.

Your protected health information (PHI) may be used and disclosed for treatment, payment, and health care operations. For example, information may be used to coordinate your care, to process billing and insurance claims through Affiliates in Counseling, and to carry out routine administrative functions of the practice.

We will not use or disclose your information for marketing purposes, and we will not sell your information. Psychotherapy notes receive additional protection and are generally not disclosed without your written authorization.

In limited circumstances, the law may require or permit disclosure of your information without your authorization. These include situations involving a serious and imminent threat of harm to yourself or others, suspected abuse or neglect of a child or vulnerable adult, or a valid court order. In each case, only the minimum necessary information is shared.

You have the right to request access to and a copy of your records, to request corrections, to request restrictions on certain uses and disclosures, to request confidential communications, and to receive an accounting of certain disclosures. You also have the right to receive a paper copy of this notice at any time and to file a complaint if you believe your privacy rights have been violated. Filing a complaint will not affect your care.

Before we begin working together, you will receive and review informed consent documents and intake paperwork. These explain the nature of therapy, confidentiality and its limits, fees, and this Notice of Privacy Practices. You are encouraged to ask questions at any point in the process.

Under the federal No Surprises Act, you have the right to receive a Good Faith Estimate explaining how much your care will cost. Self-pay and out-of-network clients are entitled to a Good Faith Estimate of expected charges for services before care begins. You will be provided with this estimate as part of your intake paperwork.

If you receive a bill that is at least $400 more than your Good Faith Estimate, you may be able to dispute the charge. Keep a copy of your Good Faith Estimate for your records.