RIGHT: To be treated courteously and considerately in a manner respecting your privacy and dignity as a person. To be treated fairly and respectfully without discrimination based on age, disability, race, color, ethnicity, religion, sex, sexual preference, or national origin.
RESPONSIBILITY: To treat medical personnel with courtesy, consideration, and without discrimination.
RIGHT: To open communication with your physician and assurance that strict confidentiality is maintained pertaining to your health and that no such records will be released without your authorization. To anticipate that your physician will assist you using resources available to effectively communicate with members who speak English as a second language as well as those who may be hearing or speech impaired. To expect a safe and secure environment which respects your right to privacy.
RESPONSIBILITY: To be open and honest with your physician, and to assist in communication supplying all the information he or she may need to provide you with quality medical care. To understand that the member’s signature on the release of information form constitutes permission for release of medical records to the PHO for the insured family members for purposes of claim payment, coordination of care, utilization management and quality assurance.
RIGHT: To provide adequate information, in terms you can understand, concerning your health problems you may have, treatment options, and prognosis as well as ways to maintain your health. To provide informed consent prior to treatment and actively participate in decisions regarding your health care. To refuse treatment to the extent permitted by law and to receive information about the consequences of noncompliance with recommended treatment plans. To be aware that refusal of treatment may result in termination of the patient-physician relationship and may jeopardize the ability of the physician to care for you properly. To receive information about preventive care protocol and participation.
RESPONSIBILITY: To consider all options and make responsible decisions. To seek furtherinformation if you are unsure about a decision. To provide the extent possible information professional staff needs in order to care for you, in order to facilitate an effective treatment plan and to cooperate with those providing health care services.
RIGHT: To be informed of all covered services and how to obtain them.
RESPONSIBILITY: To read all information provided carefully and be sure you understand it. If you have questions contact your HMO/PPO for clarification.
RIGHT: To receive all benefits of your benefit plan.
RESPONSIBILITY: To follow the rules of HMO/PPO membership.
RIGHT: To select the medical site of your choice -- you have already selected Gottlieb Memorial Hospital.
RESPONSIBILITY: To arrange all diagnostic/therapeutic procedures at Gottlieb Memorial Hospital with appropriate authorization from your Primary Care Physician (PCP). Unauthorized services are your financial responsibility. If you are not satisfied with your choice, please contact your HMO/PPO.
RIGHT: To select a Primary Care Physician for yourself and your family members. If your first choice is not satisfactory, you may select another PCP who will better meet your needs.
RESPONSIBILITY: To schedule a routine physical as soon as possible after your effective date. This is imperative in order to establish a strong patient-physician relationship. It is also most important that the physician has met you before an emergency occurs.
RIGHT: To receive evaluation/treatment from qualified specialists when your PCP feels such care is indicated.
RESPONSIBILITY: To obtain the appropriate referral form from your PCP before seeking services. For the specialist’s claim to be paid, you must have this referral before the visit. Otherwise, his claim becomes your financial responsibility. If you choose to seek care outside the PHO network, you will have to pay related costs(This, of course, does not apply to acute emergency care).
RIGHT: To obtain appointments for care within a reasonable time period consistent with your medical need -- whether it is routine, urgent, or emergent.
RESPONSIBILITY: To keep scheduled appointments or give as much notice as possible if you have to cancel. Repeated missed appointments may jeopardize the ability of the physician to care for you properly and may result in termination of the physician-patient relationship.
RIGHT: To have access to care 24 hours a day.
RESPONSIBILITY: To use your PCP for all routine care. In the case of emergency, call your PCP for treatment advice. Your PCP has an answering service that can contact him/her at all times. However, in situations where you feel you can’t call your PCP, such as you think you may be having a stroke or heart attack, go directly to the nearest hospital emergency room. Notify your PCP as soon as possible of any treatment you receive.
RIGHT: To receive help with problems and/or questions. The PHO staff is always ready to answer questions and offer guidance. YOU also have the right to submit written complaints/grievances to the PHO for processing.
RESPONSIBILITY: To express your concerns and complaints in a calm and constructive manner
LOYOLA UNIVERSITY HEALTH SYSTEM
