Responding to feedback from Providers

We have received feedback from providers on difficulty accessing information and documentation from the Customer Service Center (CSC). As a reminder, all staff at ACANY must follow New York State Department of Health (DOH) regulations and HIPAA law to ensure each Member’s privacy. It is our responsibility to verify that consent is present in the Member’s EHR for any party requesting information about that Member. CSC staff cannot confirm that the Member receives CCO services or share information without consent. If consent is absent from the Member’s EHR, the CSC will notify the Care Management team to obtain an updated consent as applicable. 

Steps taken by the Care Manager and Customer Service Center to protect HIPAA

• Member’s consent is updated annually or when a change in Provider occurs

• HCBS Waiver Providers listed in the Member’s Life Plan are included in the consent

• To expedite a response to a request for information when consent is not on file, the Customer Service Center may suggest that the Provider send a general consent with the CCO listed, if available 

CCOs are required by the New York State Department of Health to use the DOH-5055 consent to document the Member’s approval for accessing and sharing Protected Health Information. For more information, please visit Access to/Sharing of Personal Health Information (PHI) and the Use of Health Home Consents (ny.gov).