Patient Bill of Rights and Responsibilities

The patient has the right and responsibility to

• Choose a health care provider.
• Be fully informed in advance about service/care to be provided.
• Participate in the development and periodic revision of the plan of service/care
• Informed consent and the right to decline participation, revoke consent or disenroll at any point in time.
• Be informed, both orally and in writing, in advance of service/care being provided, of the charges, including payment for service/care expected from third parties and any changes for which the patient will be responsible.
• Have one’s property and person treated with respect, consideration, and the recognition of patient dignity and individuality.
• Voice grievances/complaints regarding treatment or care, lack of respect of property or recommend changes in policy, staff, or service/care without restraint, interference, coercion, discrimination, or reprisal.
• Have grievances/complaints regarding treatment or care that is (or fails to be) furnished, or lack of respect of property investigated.
• Receive appropriate service/care without discrimination.
• Be informed of any financial benefits when referred to an organization.
• Be fully informed of one’s responsibilities.
• The right to know about philosophy and characteristics of the patient management program.
• The right to have personal health information shared with the patient management program only in accordance with state and federal law.
• The right to have personal health information shared with the patient management program only in accordance with state and federal law.
• The right to identify the staff member of the program and their job title, and to speak with a supervisor of the staff member if requested.
• The right to receive information about the patient management program.
• The right to receive administrative information regarding changes in or termination of the patient management program.
• The responsibility to submit any forms that are necessary to participate in the program, to the extent required by law.
• The responsibility to give accurate clinical and contact information and to notify the patient management program of changes in this information.
• The responsibility to notify their treating provider of their participation in the patient management program, if applicable.