NOTICE OF PRIVACY PRACTICES
Effective Date: 4/22/2026
THIS NOTICE DESCRIBES HOW MEDICAL AND MENTAL HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
This Notice of Privacy Practices (“Notice”) describes the privacy practices of Megan Panici, LCSW (“I,” “me,” or “my practice”). I am required by law to maintain the privacy of your protected health information (“PHI”), to provide you with this Notice of my legal duties and privacy practices, and to follow the terms of the Notice currently in effect.
This Notice applies to all records of the mental health care and services I provide to you, regardless of whether those records are in paper or electronic form.
HOW I MAY USE AND DISCLOSE YOUR PROTECTED HEALTH INFORMATION
The following categories describe the ways I may use or disclose your PHI. Not every possible use or disclosure is listed, but all of my uses and disclosures will fall within one of these categories.
TREATMENT
Federal law (HIPAA) permits me to use and disclose your PHI without your authorization for the purpose of providing, coordinating, or managing your mental health care. This may include sharing information with other health care professionals involved in your treatment.
However, the State of Illinois provides stronger privacy protections under the Mental Health and Developmental Disabilities Confidentiality Act (MHDDCA). Illinois law generally requires your written authorization before I may disclose your PHI to another provider, even for treatment coordination purposes. As a result, in most circumstances I will ask you to sign a Release of Information before sharing your records or communicating with another health care professional about your care.
In practice, this means your privacy is protected beyond what federal law requires. I will not share your information for treatment purposes without your explicit consent, except in limited circumstances required or permitted by Illinois law, such as a psychiatric emergency.
PAYMENT
I may use or disclose your PHI for payment purposes, such as processing your payment for services or providing you with a statement of services rendered. Only the minimum necessary information will be used or disclosed. I do not bill insurance directly on your behalf.
Upon your request, I will provide you with a superbill (a detailed receipt of services) that you may submit to your insurance company for potential reimbursement. Any submission of a superbill to your insurance company is done at your discretion and is your responsibility. I am not responsible for any disclosure of your PHI that results from your submission of a superbill to a third party.
HEALTH CARE OPERATIONS
I may use or disclose your PHI for health care operations necessary to operate my practice and ensure quality care. This may include activities such as reviewing the quality of care and services I provide, training, or other administrative functions. Only the minimum necessary information will be used.
AS REQUIRED BY LAW
I may use or disclose your PHI when required to do so by applicable federal, state, or local law. This includes, but is not limited to, the following situations:
Mandatory Reporting of Child Abuse or Neglect: I am required by Illinois law to report suspected abuse or neglect of a child to the Illinois Department of Children and Family Services (DCFS).
Mandatory Reporting of Abuse of Adults: I am required by Illinois law to report suspected abuse, neglect, or financial exploitation of an elderly or disabled adult.
Duty to Warn/Protect: Under Illinois law, if you communicate a serious threat of imminent physical harm to an identifiable third party, I may be required to take reasonable protective measures, which may include disclosing relevant information to law enforcement or the potential victim.
Judicial and Administrative Proceedings: I may disclose your PHI in response to a court order, subpoena, or other lawful process, subject to the protections of the MHDDCA.
Law Enforcement: I may disclose your PHI to law enforcement officials under limited circumstances permitted or required by law.
Serious Threats to Health or Safety: I may use or disclose your PHI if I, in good faith, believe it is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public, and the disclosure is to a person reasonably able to prevent or lessen the threat.
USES AND DISCLOSURES REQUIRING YOUR WRITTEN AUTHORIZATION
Other than as described above, I will not use or disclose your PHI without your written authorization. In Illinois, this includes disclosures for treatment coordination, as described above.
You have the right to revoke any authorization you have given me at any time, in writing. Your revocation will be effective upon receipt, except to the extent that I have already taken action in reliance on the authorization.
The following uses and disclosures will never be made without your written authorization, and in some cases may not be made even with authorization:
– Disclosure of your PHI for marketing purposes
– Sale of your PHI
– Most disclosures of psychotherapy notes (which are protected separately from general PHI)
YOUR RIGHTS REGARDING YOUR PROTECTED HEALTH INFORMATION
You have the following rights with respect to your PHI. To exercise any of these rights, please submit a written request to me at the contact information listed at the end of this Notice.
Right to Inspect and Copy
You have the right to inspect and receive a copy of your PHI that I maintain in a designated record set. I may charge a reasonable fee for the cost of copying. Please note that psychotherapy notes are not included in this right and are afforded additional protections under Illinois law.
I will respond to your request within 30 days. If I deny your request, I will provide you with a written explanation.
Right to Amend
You have the right to request that I amend your PHI if you believe it is inaccurate or incomplete. I will respond to your request within 60 days. I may deny your request under certain circumstances permitted by law and will provide a written explanation if I do so.
Right to an Accounting of Disclosures
You have the right to request a list of certain disclosures I have made of your PHI. This list will not include disclosures made for treatment, payment, or health care operations, or disclosures you authorized.
Right to Request Restrictions
You have the right to request restrictions on the ways I use or disclose your PHI for treatment, payment, or health care operations. I am not required to agree to your request in most cases, but I will consider it seriously. If I agree, I will honor that restriction.
Right to Request Confidential Communications
You have the right to request that I communicate with you about your PHI in a specific way or at a specific location. For example, you may ask that I contact you only by email or only at a particular phone number. I will accommodate reasonable requests.
Right to a Paper Copy of This Notice
You have the right to receive a paper copy of this Notice at any time, even if you previously agreed to receive it electronically. To request a paper copy, please contact me using the information below.
Right to Be Notified of a Breach
You have the right to be notified if there is a breach of your unsecured PHI. I will notify you in accordance with applicable law.
MY DUTIES
I am required by law to:
– Maintain the privacy of your PHI;
– Provide you with this Notice of my legal duties and privacy practices;
– Notify you if a breach of your unsecured PHI occurs; and
– Abide by the terms of this Notice.
I reserve the right to change this Notice at any time, as permitted by law. Any revised Notice will apply to PHI I already hold as well as PHI I create or receive in the future. I will make any revised Notice available on my website at meganpanici.com and will provide you with a copy upon request.
HOW TO FILE A COMPLAINT
If you believe your privacy rights have been violated, you have the right to file a complaint with me or with the U.S. Department of Health and Human Services, Office for Civil Rights.
To file a complaint with my practice, please contact me in writing using the information below.
To file a complaint with the Office for Civil Rights:
– Online: www.hhs.gov/ocr/privacy/hipaa/complaints
– Phone: (202) 619-0257
– Mailing Address: 200 Independence Avenue, S.W., Washington, DC 20201
I will not penalize or retaliate against you for filing a complaint.
CONTACT INFORMATION
Megan Panici, LCSW
800 Roosevelt Road, Suite E220
Glen Ellyn, IL 60137
(312) 767-8740
https://meganpanici.com
For privacy-related requests or questions, please contact me directly through the contact form on my website or via the contact information provided at the time of your intake.