Privacy Policy

Macagain Corp/Belaal Sheikh Notice of Privacy Practices Your Information. Your Rights. Our Responsibilities. Macagain Corp/Belaal Sheikh Privacy Practices Privacy Practices THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. Macagain Corp/Belaal Sheikh(“Macagain Corp/Belaal Sheikh,” “we,” or “us”) is committed to providing you with the highest quality of care in an environment that protects your privacy and the confidentiality of your health information. To that end, this notice explains our privacy practices, as well as your rights, with regard to your health information. Your Rights When it comes to your health information, you have certain rights. This section explains your rights and how to exercise them. Specifically, you have the right to: Get an electronic or paper copy of your medical record • You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. • We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee. Ask us to correct or amend your medical record • You can ask us to correct health information about you that you think is incorrect or incomplete. • We may say “no” to your request, but we will tell you why in writing, usually within 60 days of your request. Request confidential communications • You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. We will say “yes” to all reasonable requests. Ask us to limit what we use or share Page 1 out of 6 Macagain Corp/Belaal Sheikh Privacy Practices • You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to these requests. For example, we may say “no” if it would affect your care. • If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information. Obtain a list of those with whom we’ve shared your information • You can ask us for a list (accounting) of the instances we have shared your health information for six years prior to the date you ask, with whom we shared it, and why. • We will include all the disclosures except for those about treatment, payment, or health care operations, and certain other disclosures (such as any you asked us to make). We will provide one accounting per year for free but may charge a reasonable, cost-based fee if you ask for another one within 12 months. Get a copy of this privacy notice • You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. • We will provide you with a paper copy promptly. Choose someone to act for you • If you have given someone healthcare power of attorney or if someone is your legal guardian, that person (your “personal representative”) can exercise your rights and make choices about your health information. • If someone has been appointed to act for you, a copy of the document appointing that person must be provided to us. We will make reasonable efforts to ensure the person has this authority and can act for you before we take any action. File a complaint if you feel your rights are violated • Protecting your confidential information is important to us. If you feel we have violated your rights, please contact us using the information at the end of this Notice. • You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, SW, Washington, DC 20201, calling 1.877.696.6775, or visiting • We will not retaliate against you for filing a complaint either to Macagain Corp/Belaal Sheikh or to the Office for Civil Rights. Please ask us how to accomplish any of the above items by contacting us using the information at the end of this Notice. You may have to complete a form and submit your request in writing. For example, to obtain a copy, amend or restrict your medical records, or to receive a listing of disclosures you must fill out a form. The forms are avail- able by contacting Page 2 out of 6 Macagain Corp/Belaal Sheikh Privacy Practices Your Choices For certain health information, you can tell us your choices about what we share. If you have a clear prefer- ence for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions. In these cases, you have both the right and choice to tell us to: • Shareinformationwithyourfamily,closefriendsorothers involved in your care. • Share information in a disaster relief situation. • Include Your Information In A MedicalDirectory. If you are not able to tell us your preference (for example, if you are unconscious), we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety. We never share your information unless you give us written authorization: • Marketing Purposes • Sale of your information • Most, but not all, sharing of psychotherapy notes In the case of fundraising: • We may contact you for fundraising purposes to support Macagain Corp/Belaal Sheikh and its mission, but you can tell us not to contact you again for this purpose. How Macagain Corp/Belaal Sheikh May Use and Share Your Health Information Macagain Corp/Belaal Sheikh may, without your written permission, use your health information within NM and share or disclose your health information to others outside Macagain Corp/Belaal Sheikh in the following ways: For treatment, payment, and healthcare operations Macagain Corp/Belaal Sheikh may use and disclose your health information without your written authorization for treatment, payment and health care operations. a. Treatment • Macagain Corp/Belaal Sheikh may use your health information and share it with other professionals who are treating you. For example, a physician/party treating you for an injury or providing you a tests may ask another physician/parties about your overall health condition. Note, however, that we may ask for your written permission if certain kinds of information are being disclosed (such as mental health information). • Macagain Corp/Belaal Sheikh may keep your information electronically using Medifusion and other electronic medical record systems. In addition, many physicians/parties and across the United States and world also use medifusion. Where possible, Macagain Corp/Belaal Sheikh does participate in the “Medifusion/Jotform” program and other similar programs that allow clinicians/parties from different organizations across the country to electronically and securely exchange patient medical information for treatment purposes. For example, suppose you are visiting California and injure yourself. If the California hospital that treats you uses Medifusion and participates in the MedifusionCare Everywhere program , the California hospital may obtain your Macagain records from Medifusion or by contacting us at In some cases, you may be asked to give permission to allow the sharing of your health information. Page 3 out of 6 Macagain Corp/Belaal Sheikh Privacy Practices b. Payment Macagain Corp/Belaal Sheikh may use and share your health information to bill and get payment from health plans or other entities. For example, we may send health information about you to your health insurance plan so it will pay for your services. We may also disclose your information to other providers for their payment activities. c. Healthcare operations Macagain Corp/Belaal Sheikh may use and disclose your health information to run our organization, improve your care, and contact you when necessary. For example, we use health information to manage your treatment and services, including to contact you to remind you that you have an appointment for medical care. We may also disclose information to clinicians, residents and fellows, medical students,and other authorized personnel for educational and learning purposes. Those instances that require the use or disclosure of your health information Macagain Corp/Belaal Sheikh may disclose your health information without your written permission: • With some limited exceptions, to you or someone who has the legal right to act on your behalf (your personal representative). • To the Secretary of the Department of Health and Human Services, if necessary, to make sure your privacy is protected. • When required by law. Other purposes for which Macagain Corp/Belaal Sheikh is allowed or required to use or disclose your health information Macagain Corp/Belaal Sheikh may use or disclose your health information to others without your written permission in other ways — usually in ways that contribute to the public good, such as public health and research. We must meet many conditions in the law before we can share your information for these purposes. For more information see: hipaa/understanding/consumers/index.html. Examples include: a. To help with public health and safety issues Macagain Corp/Belaal Sheikh may share health information about you for certain situations such as: • Preventing disease • Helping with product recalls • Reporting adverse reactions to medications • Reporting suspected abuse,neglect or domestic violence • Preventing or reducing a serious threat to anyone’s health or safety b. To address workers’ compensation, law enforcement, and other government request, billing purposes Page 4 out of 6 Macagain Corp/Belaal Sheikh Privacy Practices Macagain Corp/Belaal Sheikh may use or share health information about you: • For Workers Compensation Claims • For law enforcement purposes or with a law enforcement official • With health oversight agencies for activities authorized by law • For special government functions such as military, national security, and presidential protective services f. To respond to lawsuits and legal actions Macagain Corp/Belaal Sheikh may disclose health information about you in response to a court or administrative order, or non-sensitive information in response to a subpoena if there is a qualified protective order or satisfactory assurances. g. To business associates Macagain Corp/Belaal Sheikh may disclose your health information to our “business associates” — individuals or companies that provide services to Macagain Corp/Belaal Sheikh For example, a business associate would include the company that administers the billing claims for Macagain Corp/Belaal Sheikh a software vendor, a telehealth or other digital health solutions company, and other service providers. Macagain Corp/Belaal Sheikh requires that business associates keep your information safe. H. To parents and legal guardians of minors Macagain Corp/Belaal Sheikhmay share a minor’s health information with his or her parents or guardians unless such disclosure is otherwise prohibited by law. For example, a minor’s parents may discuss medical treatment with the care team. Note, however, that if a minor is emancipated, married, pregnant or a parent, we will not share information with the minor’s parents or guardians. Also, if a minor is receiving certain types of treatment (such as genetic or HIV testing; testing for sexually transmitted diseases; mental health, or drug or alcohol abuse counseling; or other certain types of treatments), we will not disclose information to the minor’s parents or guardians except in certain situations as required or allowed by law (including, but not limited to, if doing so is necessary to protect the minor’s safety or that of a family member or other individual or if, in the professional judgment of the health care provider, notification would be in the minor’s best interest and we have first sought unsuccessfully to persuade the minor to notify his or her parents). Some Illinois and federal laws provide additional privacy protection of your health information. These include: • Sensitive health information. Some types of health information are particularly sensitive, and the law, with limited exceptions, may require that we obtain your written permission or in some instances, a court order, to use or disclose that information. Sensitive health information includes information dealing with mental health and developmental disabilities, HIV/AIDS, alcohol and drug abuse treatment, genetic testing and genetic counseling. Prior to receiving care from Macagain Corp/Belaal Sheikh, a patient signs, where required by law, a consent to allow Macagain Corp/Belaal Sheikh to use and disclose sensitive health information in the same way that the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) allows us to use and share non-sensitive health information for treatment, payment and healthcare operations as described in this Notice. For example, Macagain Corp/Belaal Sheikh may use and share sensitive health information in order to better coordinate care for Macagain Corp/Belaal Sheikh patients. • Information used in certain disciplinary proceedings. State law may require your written permission if certain health information is to be used in various review and disciplinary proceedings by state health oversight boards (such as the Department of Professional Regulation). • Information used in certain litigation proceedings. State law may require your written permission for certain providers to disclose information in certain legal proceedings. • Disclosures to certain registries. Some laws require your written permission if we disclose your health information to certain state-sponsored registries. Macagain Corp/Belaal Sheikh is committed to following all state and federal legal requirements. Page 5 out of 6 Macagain Corp/Belaal Sheikh Privacy Practices Our Responsibilities • We are required by law to maintain the privacy and security of your protected health information. • We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information. • We must follow the duties and privacy practices described in this Notice and offer you a written copy of it. • We will not use or share your information other than as described here unless you tell us we can do so in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind. Changes to This Notice We can change the terms of this Notice, and the changes will apply to all information we have about you. The new Notice will be available upon request at and at many of the offices where we treat patients, and on our website. However, any changes to the terms will not change Macagain Corp/Belaal Sheikhcommitment to complying with applicable laws and ensuring the privacy of patient information. This Notice will be followed by: • All organizations required to have a Notice of Privacy Practices and owned or controlled by Macagain Corp/Belaal Sheikh (referred to together with Macagain Corp/Belaal Sheikh,” “we,” or “us”). A complete listing of organizations is available from This Notice applies to all Macagain Corp/Belaal Sheikh locations that provide medical services; • Independent physicians on the medical staff of an Macagain Corp/Belaal Sheikh hospital when providing care at an Macagain Corp/Belaal Sheikh location. These independent physicians/parties, however, are legally separate and responsible for their own acts, and Macagain Corp/Belaal Sheikh are not responsible for the clinical services provided by the physicians/parties to you at an Macagain Corp/Belaal Sheikh locations; and • Other healthcare professionals/parties who treat you at any Macagain Corp/Belaal Sheikh location, including residents, fellows, students and trainees. For purposes of complying with federal privacy and security requirements, some Macagain Corp/Belaal Sheikh organizations (e.g.Macagain Corp/Belaal Sheikh,) may designate themselves as an affiliated covered entity ( abbreviations or name would be here). This means that these organizations act together as one organization for purposes of privacy law. How does that affect you? It means that if you ask for a copy of your medical records, we will provide your records from all of these organizations. You do not have to make separate requests. In addition,Macagain Corp/Belaal Sheikh organizations have established one or more organized health care arrangements. This means that your health information may be shared between these organizations for purposes related to their operating together as a health system, including the provision of treatment, for payment purposes, and for a broad scope of healthcare operations, which may include joint utilization review, credentialing, education, risk management, patient safety, quality assessment and improvement activities. Who To Contact For Information or With a Complaint If you have any questions about this Notice, or any complaints, please contact us at, or in writing at the address below or via email as stated. Corporate Compliance and Integrity Macagain Corp 3650 SAVANNAH PL DULUTH, GA 30096-4898 EFFECTIVE DATE OF THIS NOTICE This Notice is effective as of Sept 12, 2022. © 2022 Macagain Corp/Belaal Sheikh. All rights reserved. Page 6 out of 6