Effective Date: July 1, 2024
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Before you give your informed consent to request and receive behavioral health services remotely (“Virtual Care Services”), please be aware of how obtaining health services remotely from a Brightline Medical Associates, P.A. and its affiliated entities, including, but not limited to Brightline Medical Associates of California, Inc., Brightline Medical Associates of Kansas, P.A., and Brightline Medical Associates of New Jersey, P.A., and their engaged clinicians (collectively, “BMA”) licensed clinician or Brightline coach (collectively, “Care Team”, “we”, “us”, or “our’) through an online virtual care platform and properties offered by Brightline, Inc. (the “Product”) differs from in-person care. When you request to receive services for your child from our Care Team, those services are outlined in the attached Member Services Agreement, as well as the discussions between you, a legal parent/custodial legal guardian, and your Care Team. The terms “you” and “yours” refer to the member using the Product to request Virtual Care Services from our Care Team. Please read each item carefully.
BMA provides virtual mental health care for children and teens ages 0 to 18 years, and their families through therapy, psychiatry (medication management), or non-clinical coaching services through its affiliate, Brightline, Inc. (“Brightline”), our technology partner, (collectively “Services”). Brightline, Inc. does not provide clinical services; it performs administrative services, payment, and other supportive activities for BMA.
Brightline has also partnered with the California Department of Health Care Services to offer BrightLife Kids for any family living in California with kids 0-12 years old. Parents and caregivers can turn to BrightLife Kids for peer support and expert advice on how to handle behavioral challenges while teaching resilience, problem-solving, and communication.
Telehealth involves the use of audio, video, or other electronic communication to enable your Care Team to interact with you and provide coaching, therapy, medication management and member education from a remote location. Video-conferencing technology will be used by your Care Team to facilitate the telehealth session. With your consent, in certain cases, your Care Team may record sessions for quality reviews, operations, training, research and safety purposes. We may also request that you provide videos of you to assist in care and treatment. Those videos will be used internally by the Care Team for treatment and care coordination purposes.
You understand that a video session will not be the same as an in-person visit with a therapist, prescriber, or behavioral health coach due to the fact that you will not be in the same room as my therapist, psychiatrist or behavioral health coach.
The benefit of telehealth includes the ability for you to access your Care Team from your home or other location using the Internet. Potential risks of the Brightline telehealth platform include:
You and your Care Team won’t be in the same room, so it may feel different than an in person setting.
Immediate care may not be available at all times.
Technical problems such as unclear video, loss of sound, or connection interruption that may require a session to be rescheduled.
In rare circumstances, security measures could fail causing a potential breach of personal medical information. We use telehealth technology that is designed to protect your privacy. All the services delivered to you through telehealth will be delivered over a secure connection that complies with the requirements of the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”).
A lack of access to complete medical records could result in adverse drug interactions, allergic reactions, or other errors.
Other considerations:
Telehealth may not be appropriate for the treatment of certain symptoms or diagnoses that would benefit from the availability of an in-person appointment. Your Care Team may refer your case elsewhere in these circumstances.
Specific telehealth coverage rules per your insurance
You understand that you, or my Care Team, may discontinue or reschedule a telehealth session if the video quality or audio connection is not adequate for the situation.
You understand and agree that you should never use the Product in a medical emergency. You understand and agree that in a medical emergency you should dial 911 or visit an emergency room. Our services are not designed for acute treatment of severe behavioral health systems. In the event you are experiencing emotional distress, please contact the National Suicide Prevention Hotline: Crisis Text Line at 1-800-273-8255, text 988, or text “Home” to 741-741, to obtain immediate assistance.
Personal information that Brightline uses or maintains, including your telehealth sessions and communications, is confidential and subject to laws that protect health information, including the Health Insurance Portability and Accountability Act (HIPAA) pursuant to Brightline’s Privacy Policy and Notice of Privacy Practices. For more information, see our Notice of Privacy Practices.
In cases where the Care Team is asked to work collaboratively with a family’s external stakeholders, such as a child’s pediatrician or school, we use a Release of Information form to seek written permission to exchange information with external stakeholders. Further, in cases where a child exhibits signs of emotional disturbance, as defined under Sec 300.8(c)(4) of the Individuals with Disabilities Education Act, we are required to inform the child’s school as required under federal law.
Information you disclose to your Care Team is kept confidential within the limits of state and federal law. Communications between the child and Care Team are typically confidential, unless the law requires their disclosure. Your Care Team will inform you of the legal exceptions to confidentiality, and should such an exception arise, will share only such information as required by law. Examples of such exceptions include but are not limited to:
abuse of a child;
abuse of an incapacitated adult;
Health Information Portability and Accountability Act (HIPAA) regulation compliance;
certain rights you may have waived when contracting for third party financial coverage;
orders of the court; and
significant threats to self, others or property.
Except for situations such as those mentioned above or when required by law, we will not share specific details for what occurs in sessions with parents or caregivers. We will share general information (e.g., care approach, recommended ways that caregivers support their youth in care) with parents or caregivers so that you can support your child's experience with Brightline. This may include information such as scheduling details, your child’s care plan, and general progress that you should know about.
You play a vital role in protecting your privacy as well. We ask that when engaging in our services, you are providing a quiet, safe and secure environment for your child to engage with their Care Team during each session. Do not take pictures, videos or otherwise make any recordings absent permission from your Care Team.
You understand that your healthcare information may be shared confidentiality with my Care Team and other authorized individuals when required for my treatment, healthcare operations, and billing purposes.
You must be located in the US and, for clinical services including therapy and medication management, in the state where you maintain legal residence and where your BMA clinician is licensed to practice.
If you are in an area where your BMA Clinician is not licensed, your session will need to end and be rescheduled with a clinician who is licensed in that location.
A fast and clear internet connection that is both private and secure.
You cannot be driving, in a motor vehicle, or in a public place during sessions.
There is a very small chance that someone could use technology to hear or see your telehealth visit.
A sensitive microphone that enables you to be able to speak and hear well.
A video camera that is positioned so that we can see you.
We require a legal parent/custodial legal guardian to be available and regularly involved in sessions with their child, based on our model of care.
We understand the role bonus parents play in the family unit and do require a signed release form from the legal parent if they are fulfilling this role in their absence.
If the child’s legal guardian is not able to be in attendance, please ensure your Care Team is made aware in advance of the child’s session. We will need a good phone number to reach the guardian and they must be available in case of an emergency.
You are responsible for providing accurate and complete information regarding your child’s health and health care, which includes any custodial arrangements with all legal parties of the child who need to be a part of and consent to the minor’s treatment.
You understand that if you are not properly prepared for your session, as indicated above, and/or not located in the state of residence provided to us in the registration, we will not be able to continue forward with your session and will be caused to reschedule.
Your first session is a “welcome visit” that will involve introductions and an evaluation of your needs. The purpose of the initial visit is to obtain a detailed history and perform a comprehensive evaluation to ensure the services you selected are best matched in addressing your goals. If you are involved in our clinical services, we may also request information from your child’s other healthcare providers and from their school before making a working diagnosis and/or treatment recommendations. If a guardian wants to be part of their dependent’s care, they must be with the child during the session.
You have evaluated this information along with your own opinions of whether you feel comfortable moving forward. You understand that you can ask any questions about our care as they arise. If you decide that you do not want to use telehealth services for you or your child at any time, this will not result in a loss of your health program benefits or your rights to future health care.
Brightline is available to you through (a) employers we partner with, (b) health plan and EAP clients we contract with, and (c) self pay. Amounts charged may vary depending on your specific situation.
When applicable, Brightline will bill your health plan and/or employer for services provided.
Pricing for our services is available to you before booking a session.
You can learn more about our payment structure on the Brightline web/mobile app and in our Financial Agreement / Assignment of Benefits Policy before booking an appointment.
You understand that you are responsible for payment of any deductible, coinsurance, or co-pay amounts as stipulated by your insurance plan.
You have the opportunity to ask your Care Team questions about telehealth prior to receiving the services to better understand the risks, benefits and any practical alternatives described in this consent.
If at any time you do not feel safe using telehealth, please disclose this to your Care Team. Your Care Team will make every effort to discuss these concerns with you, but has sole discretion in determining whether to discontinue care via telehealth if necessary. You have the right to make informed decisions about your care including the right to ask for a referral to another provider, and the right to refuse or terminate care, to the extent permitted by law.
If you sign this document, you agree that:
You have read this form and fully understand its contents including the risks and benefits of telehealth.
You understand that you have the opportunity to ask questions prior to receiving the services including any alternatives to care as described above.
You want to engage in Brightline services and consent to telehealth as an acceptable form of delivering healthcare services to you and that this consent will cover any and all of your sessions using telehealth.
Effective Date: July 1, 2024
Welcome to Brightline! This document, along with the Informed Consent above (collectively, the “Agreement”) contains important information about our professional services and business policies. When you sign this document, it will represent an agreement between us. Although this document is long and sometimes complex, it is very important that you read it carefully. If you agree to these terms we will assume that you have read, understood, and agree to its contents.
We reserve the right, at our sole discretion, to change, modify, add or remove portions of these terms, at any time. It is your responsibility to check these terms periodically for changes. The date of change will be shown next to “Effective Date” at the top of this page. Whenever material changes to this Agreement are made, we will provide you with notice before the modifications are effective by sending a message to the email address associated with your account, or by posting a notice to your user account. By continuing to access or use the Services after changes to this Agreement become effective, you agree to be bound by the revised Agreement. If any changes are unacceptable to you, you should stop using the Services.
When you become a Brightline member, you get access to the Brightline mobile or desktop application (“Brightline App”), our Member Support Services, and to Brightline behavioral health care providers.
The Brightline App provides personalized content and interactive resources for you and your family, simple tools for scheduling appointments and billing, serves as your hub of information including guided activities, and connects you to your Brightline coach or if you choose clinical care, a BMA clinician.
The Digital Platform houses self-serve resources and enables asynchronous practice, skill-building, and communication for members engaged in Prevention & Early Intervention, and Treatment Services. As a member, you will have access to needs-based, self-guided content bundles, including personalized and interactive assessments, and topic-based exercises, videos, and articles
Digital assessments that support needs identification, care navigation, and outcomes measurement across Services
Digital Moderated topic-based discussions and workshops, in the form of webinars
Access to Brightline Member Support team via chat (and provider team once engaged in Early Prevention & Intervention or Treatment Services
Information submitted during the course of completing interactive surveys or exercises in the Brightline App will not be actively monitored, but may be used to tailor recommendations for programs or for your care plan. If you need to contact your Brightline coach or member support, they should be messaged directly.
Your journey with Brightline starts with completing your onboarding through the Brightline App. You will initially be asked to complete a series of questions that helps Brightline understand if coaching or therapy services might best support your needs. You will receive appropriate care options given the initial needs of your child, with choice between our services when appropriate. Once you choose the service line that you want to pursue, you will be able to review bios and have the option to select a Care Team member that meets your specific needs and preferences.
Offered through our Coaching services, we provide individualized support plans tailored through a member’s care journey to address families’ evolving needs; designed for children and parents/caregivers a) with common non-clinical needs (e.g., social-emotional learning, self-worth, organizational skills), b) who are not ready for formal clinical treatment, or c) who have graduated from treatment and need maintenance care. Coaches then practice these skills with the child, motivating them to work towards positive change and reaching their goals.
Your initial session will be an introduction to (i) establish the coaching relationship, (ii) evaluate your specific needs, (iii) discuss your current situation, what a successful experiences looks like for you and determine how Coaching may support you in your goals, and (iv) explore what has worked in the past and identify any obstacles in preventing you from achieving your goals. Your coach can help answer questions related to skills introduced in the Brightline App. If coaching is the right fit for you, subsequent sessions will be focused on developing an action-oriented plan with goals, in partnership with you, in an effort to establish new positive behaviors. In between sessions, you are encouraged to reach out to your coach with any follow-up questions or advice via the Brightline App async chat during normal business hours. Coaching sessions may occur through video conference or through Brightline chat depending on the venue that works best for you and your plan selection.
Brightline Coaches hold either a Master’s degree or a Bachelor’s degree with coaching certification, with experience in child and family behavioral health coaching based in Cognitive Behavioral Therapy (CBT) and motivational interviewing, as well as training through our Brightline Academy. Brightline coaches are not licensed mental health professionals and are not able to diagnose or treat clinical difficulties, such as major depressive disorder or generalized anxiety disorder. If the need for higher-level care is identified, you will be connected with a licensed therapist and your Care Team will coordinate and share among themselves information you or your child have provided, and work collectively to support high quality and effective care for your family. Coaches participate in a rigorous quality assurance and oversight program, have opportunities for consultation with peers and, and in some instances consult with a qualified licensed clinician as needed.
You understands coaching is not therapy and does not substitute for therapy if needed, and does not prevent, cure, or treat any mental disorder or medical disease
The clinical team provides diagnosis and treatment for a range of mental health conditions and areas, including but not limited to, anxiety, depression, disruptive behaviors, trauma and stressor-related disorders, and attention deficit/hyperactivity disorder. Therapy interventions at Brightline are designed to be delivered as short-term, outpatient care and involve evidence-based approaches such as Cognitive Behavior Therapy (CBT), Dialectical Behavior Therapy (DBT) and Parent Management Training (PMT), to name a few. Therapy may involve you and your child or just you, depending on the age and presenting characteristics/concerns of your child. These approaches have been shown to be effective treatments for mental and behavioral health concerns.
Your first session is a period for you and your therapist to get to know each other and get an idea of how you collectively want to proceed in establishing a treatment relationship. This first evaluation appointment is also important for the clinician to fully assess yours and your child’s concerns to arrive at an initial diagnosis and treatment plan. During this process, clinicians consider if the member is an appropriate fit for Brightline therapy based on this initial assessment. For those who are a good fit for therapy at Brightline, clinicians will inform parents/caregivers of the goal-directed, episodic nature of care (i.e., not intended for multi-year long therapy) and collaboratively develop a treatment plan with the family about what goals they will focus on and how they will go about achieving them. Future visits will entail setting goals, learning new skills (for both you and your child or just you as a caregiver), trying out those skills, and adjusting the plan based on response to these interventions. Therapy sessions are live interaction sessions through video conference in the state where the child resides and your clinician is licensed to practice.
Brightline only hires therapists with the applicable required education, training and licensure. You can learn more about your clinician’s background and area of speciality through the bio sent to your email. BMA licensed therapists are not physicians and cannot prescribe medication. Depending upon your and your child’s specific needs, your therapist may suggest additional services with other members of our team—specifically, our broader team of licensed nurse practitioners or physicians (psychiatrist, pediatrician) (each, a “Prescriber”) can provide medication, evaluation and support for treatment related to medical and biological origins. If you and your BMA therapist or Prescriber believe that other specialty care services might be helpful, they may refer you to these services outside of Brightline via your health plan or employer for in-network referrals. If treatment needs fall outside the scope of practice for our BMA clinicians, we may refer you to your health plan or employer for in network referrals. BMA therapists and Prescribers will always discuss such recommendations with you. If you agree, our team will work together to provide you and your child with cohesive care and support.
Brightline is a “therapy-first” approach. The decision to prescribe medication would be a shared decision making process between therapist(s) and member/family only after a therapy relationship is established. If you request a medication consultation, your therapist will engage one of our Prescribers to meet with you, provide a medical evaluation, and discuss risk and benefits of medication management. Once a child starts a prescription, Brightline will schedule regular meetings with you, your child, and your Prescriber to follow up and assess progress and response to medication. The frequency and timing of these meetings will depend on the Prescriber’s clinical judgment as well as standards of care and best practices. Medication management sessions are live interaction sessions through video conference in the state where the member resides and your clinician is licensed to practice.
Once your child has achieved their treatment goals, your Care Team lead will work with you and your child to transition out of active care. At this point, you will no longer have regular therapy visits, but you will continue regular visits with your Prescriber if appropriate. You will continue to have access to the Brightline App, coaches and support from your Care Team for additional services if needed.
Brightline has partnered with Wisdo to provide evidence-based peer support communities to parents and caregivers and will allow you to connect and learn from others like you around a variety of topics and concerns. Through communities you will also have access to articles and tools for skill building relevant to the community topics, and guidance from coaches who will help moderate the community discussions. Brightline disclaims all liability for content provided on the Wisdo platform.
Coaching programs vary in length depending on the needs of a member. The duration of therapy varies depending on the care plan that the therapist develops with you during your first two sessions. These sessions may occur weekly or less than weekly. We will do our best to ensure a regular schedule, but times are subject to change depending upon your schedule and your Care Team Member’s availability.
Sometimes these sessions will be held with only your child, sometimes with only you, and sometimes you and your child together. For example, in therapy, we may ask for only your child to attend the first half of a session, and for you to join for the second half. Your Care Team will work with you to outline the schedule in advance and identify who needs to attend each session.
Our Coaching sessions are up to 30 minutes in length. Our Therapy consultations begin with an initial 55 minute intake appointment and subsequent sessions can vary between 30 minutes to 55 minutes in length depending on your care plan needs, the type of appointment, and the attendance of you, your child or both.
Beginning and finishing on time is an important part of ensuring progress and adherence to your child’s care plan. Attendance and engagement is a key part of successful treatment and building the relationship between you and your Care Team member. This commitment ensures your child is receiving high quality care. Scheduling follow up visits is encouraged within one week post initial welcome session in order to reserve slot availability, otherwise preferred scheduling preference for recurrence in time slots may not be available. Availability is subject to change depending upon the member/caregiver(s) schedule and providers availability.
If you are ever running late, please let your Care Team member or Member Support know as soon as possible. If you arrive more than 10 minutes late for a scheduled appointment, your Care Team member may determine that there is not ample time remaining and request you to reschedule your appointment. Not attending or joining a session well past the majority of your scheduled time will be considered a “no-show” occurrence. If for any reason your Care Team lead is running late to session, you will receive a notification at the 5-min mark to update you on the status of your session start time or you can contact Member Support at 1-888-224-7332 or email at [email protected] if your Care Team lead has not arrived within 5 min of session start time. If for any reason your Care Team lead arrives more than 10 minutes late to an appointment, you may assume that the session is canceled and you will not be responsible for any payment for that session.
We reserve your appointment time specifically for you and your child. A late cancellation or no-show has an impact and means that we were unable to serve another person. If we have enough notice of a cancellation, we can provide help to someone else. For this reason, we require a 24-hour advance notice for cancellations and re-schedules. Brightline reserves the right to charge up to a $75 fee if you cancel or no-show within 24 hours, except as may be prohibited by law or third party payors.
Canceling or missing more than 25% of your monthly sessions or two consecutive sessions, will be considered an attendance concern. If this happens, you will be asked to meet with your Care Team lead to review the care plan and discuss if an alternative schedule will be more appropriate. If you repeatedly miss scheduled appointments, and if Brightline is unable to contact you for a period of 30 days, you understand that your agreement with Brightline may be terminated and you will be removed from Brightline’s platform.
Our family-centric platform is generally intended for caregivers or guardians to facilitate children’s access to care from the ages of 0-18 years old.
Children under 18 years of age, who are not emancipated, are not eligible at this time to directly self-register for the Services without the authorization of a guardian. Please note certain state patient privacy laws may permit a child to directly obtain certain types of health care services independent of their parent or guardian. To learn more, please refer to the Children’s Privacy section of our Privacy Policy.
For children between 12 and 18, because privacy in psychotherapy is often crucial to successful progress, information your child discloses during session is kept confidential, unless the law requires their disclosure. Your clinician will inform you of the legal exceptions to confidentiality and outside of those exceptions, your clinician will not share specific details for what occurs in session with parents or caregivers unless explicitly agreed upon with the child in care. General information, such as treatment approach and recommended ways that caregivers support their youth in care, will be shared with parents or caregivers so that you can support your child’s experience with Brightline. This is further discussed at the initial start of Therapy and is outlined in our Therapy Professional Disclosure Statement under “Your Rights under HIPAA”. Any other communication will require the child's verbal consent unless the Care Team feels that the child is in danger or is a danger to someone else.
In order to authorize mental health treatment for your child, you must be the child’s legal guardian. The parent registering the child for care MUST sign our Divorced, Separated, and Multiple Caregiver Policy. The Care Team will not provide care for the child without this. To learn more about our policy on divorced, separated, and multiple caregivers (to include bonus parents, legal proceedings and custody arrangements), please refer to our Divorced, Separated, and Multiple Caregiver Policy.
One risk of child therapy involves disagreement among parents and/or disagreement between parents and the child’s Care Team regarding the child’s care. If either parent with the appropriate authority decides that behavioral health services should end, Brightline will honor that decision, unless there are extraordinary circumstances. However, in most cases, we will ask that you allow Brightline the option of having a few closing sessions with your child to appropriately end the treatment relationship.
Please be aware that Brightline’s patient is the child - not the parents/guardians nor any siblings or other family members of the child. Furthermore, any communication by a parent to Brightline or our Care Team may be legally disclosed to the other parent, unless that parent’s parental rights have been terminated. A parent should NOT share any information which they are not willing to have disclosed to any other party with parental rights in the child’s care.
Your participation is important, and often essential, to the success of the treatment. This section is intended to inform you about the risks, rights and responsibilities of your participation as a collateral participant (“CP”). Your agreement and signature, below, indicates your understanding of your role as a collateral and the limitations therein. If you have any questions or concerns about what it means to be a CP, and especially if you have questions or concerns about information that may be shared with another parent, it is critical that you discuss these questions/concerns with your Care Team.
Who and what is a collateral?
In the context of Brightline, a collateral participant is usually a parent or caretaker who participates in therapy to assist the child. The CP is not considered to be a patient and is not the subject of the treatment. Our clinicians primary responsibilities are to the child with respect to treatment. Our providers also have certain legal and ethical responsibilities to patients, and the privacy of that relationship includes certain legal protections. That privacy protection does not apply to CPs.
The role of collaterals in therapy
The role of a CP varies greatly. For example, a CP might attend only one session, either alone or with the child, to provide information to the Care Team and never attend another session. In another case a collateral might attend all of the child’s therapy appointments and their relationship with the child may be a focus of the treatment. Your child’s Care Team will discuss your specific role in the treatment at your first meeting and at other appropriate times.
Our behavioral health record includes information about the reason your child is seeking Brightline services, a description of the ways in which problems impact your child's life, a diagnosis, plan of care, goals setting, progress made towards those goals, and past or relevant medical or social history, and may include past treatment records that we have received from other providers, reports of any professional consultations, billing records and any reports that have been sent out to anyone, including reports to your insurance carrier. Except in unusual circumstances that involve danger to yourself and others, you may examine and/or receive a copy of your child’s behavioral health record if you request it in writing. If we refuse your request for access to your behavioral health record, you have a right of review, which we will discuss with you upon your request.
No separate medical record or chart will be maintained on you in your role as a collateral.
However, your demographic information will be maintained as part of your child’s record, and information you provide may be entered into your child’s chart, if appropriate. Your child and other adults with a right of access to health records may have a right to access the chart and the material contained therein, which may include information and communications you have provided. Other adults with a right of access to the chart / record may also have access to the information / communications you provide. There will not be a diagnosis assigned to you in your role as a collateral and there is no individualized treatment plan for you.
Behavioral health records will be kept for a minimum of 7 years from the date of last treatment or until the child turns 21, whichever is longer.
The confidentiality of information in your child’s chart, including the information that you provide, is protected by both federal and state law. However, as a CP you are not the individual directly receiving care or treatment, but rather you are assisting in the clinical care of a child.
Clinicians specializing in the treatment of children have long recognized the need to treat children in the context of their family. In treatment involving children and their parents, access to information is an important and sometimes contentious topic. Particularly for older children, trust and privacy are crucial to treatment success. Parents may need to know certain information about the treatment, especially when the potential for harm to the child or others is suspected. For this reason, your child’s clinician may elect to discuss what information will be shared and what information will remain private, in accordance with applicable state law.
Brightline is committed to a partnership agreement with you and your child in providing family centered care. It is our mission to provide compassionate care in an environment that promotes comfort, healing, and mutual respect between you, your family members and your Care Team. We have outlined the expectations below that we ask of your family and our Care Team:
Demonstrate respect and consideration for all parties involved. We believe that diversity, equity, inclusion, and belonging (DEIB) are essential to the foundation upon which we build our mission.
Creating a safe environment. We are committed to creating an environment that encourages your child to show up authentically in a space where they can thrive and that everyone feels valued and respected.
Inclusivity: We embrace and celebrate the unique experiences, perspectives and cultural backgrounds that each family brings to Brightline and have made an inclusive Care Team available to you in meeting your needs.
Threats, violence, disrespectful communication or harassment of any member of the Brightline community for any reason will not be tolerated.
You understand and agree that you, and every party associated with your account will treat Brightline Care Team and staff with respect and will not engage in inappropriate, abusive, or hostile actions (verbal or otherwise). Doing so may result in termination from your care at Brightline.
A federal law, called the Genetic Information Nondiscrimination Act (GINA), generally makes it illegal for health insurance companies, group health plans, and most employers to discriminate against you based on your genetic information. Genetic information includes information about an individual's genetic tests and the genetic tests of an individual's family members, as well as information about the manifestation of a disease or disorder in an individual's family members (i.e. family medical history). Brightline may ask information about your family medical history relevant to tailoring our services and a care plan best suited to your childs' needs.
This law generally will protect you in the following ways:
You may select "no response" to any questions Brightline asks about your child's family history.
Your health insurance company and/or group health plan may not request your genetic history information that we get as a healthcare provider.
Your health insurance companies and/or group health plans may not use your genetic information when making decisions regarding your eligibility or premiums.
Your employer, with 15 or more employees, may not use your genetic information when making a decision to hire, promote, or fire you or when setting the terms of your employment.
Be aware that new federal law does not protect you against genetic discrimination by companies that sell life insurance, disability insurance, or long-term care insurance, nor does it protect you against genetic discrimination by all employer
Use of Brightline’s services requires the collection of the personal information about your child. Your consent is required for the collection, use, and disclosure of your child’s information and we have collected your information in order to obtain this consent. We will not collect your child’s personal information without your consent. However, if you do not give your consent, your child may not use our services.
Your agreement below constitutes your consent to the collection, use, and disclosure of your child’s information, as described in this Agreement and the Brightline Privacy Policy. A parent or guardian may revoke this consent at any time. However, once consent is revoked, a child may not use our online services again unless a new Informed Consent for Telehealth Services / Member Services Agreement is signed. To revoke your consent, we ask that you submit the request via email to [email protected]. It will be effective upon our receipt of your email.
You have the right to communicate complaints regarding your care or the care of your child. Should you wish to make a formal complaint about one of your child’s care Care Team leads, you may do so in writing and submit the concern to us at [email protected].