FAMILY CHOICE OF NEW YORK,
LLC
Notice
of Privacy Practices
60 Innsbruck Drive - Cheektowaga, New York 14227
John Walker, Executive Director
Telephone 800-506-7051 or 716-668-7051
Effective
Date: January 1, 2008
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.
FAMILY CHOICE OF NEW YORK, LLC
(“FCNY”) understands the importance of maintaining the confidentiality of your
medical and personal information and is committed to maintaining the
confidentiality of such information. In
our provision of services for you and your health plan, we create and obtain
various records concerning your medical condition, the care and treatment
provided on your behalf and your payment for medical services. We use these records to ensure you receive
the best possible medical care, to obtain payment for services provided for you
and to enable us to meet our professional and legal obligations. FCNY is required by law to maintain the
privacy of your personal information and to provide you with this notice of our
legal duties and privacy practices with respect to such information. If you have any questions about this notice,
please contact the Privacy Official identified above.
A. Use and Disclosure of Your Health
Information
In
its provision of services, FCNY obtains health information about you and stores
it in paper form and on computers. This
compilation of information is commonly referred to as your medical record. The information contained in your medical
record includes information that enables us to identify and contact you (for
example, your name, address, phone number, etc.), information about your
medical condition and the treatment of your medical condition and information
about sources of payment for your medical care, among other things. The medical record is the property of FCNY
and/or your health care provider, but the information in the medical record
belongs to you. The law permits FCNY to
use and disclose the information in your medical record for the following
purposes:
1. Treatment. FCNY
