Member’s Rights &
Responsibilities
SHP Members have the right to:
* be treated with courtesy and respect, and with due consideration of
his/her dignity and privacy.
* receive information on available treatment options and alternatives,
presented in a manner appropriate to the enrollee’s condition and ability to
understand.
* participate in decisions regarding his or her health care, including
the right to refuse treatment.
* be free from any form of restraint or seclusion used as a means of
coercion, discipline, convenience or retaliation.
* request and receive a copy of his or her medical records, and request
that they be amended or corrected.
* be furnished health care services in accordance with federal and state
regulations.
The State must ensure that each enrollee is free to exercise his or her rights,
and that the exercise of those rights does not adversely affect the way the
health plan and its providers or the State agency treat the enrollee.
They also have the right to
* Receive a prompt and reasonable response to questions and requests
* Know who is providing medical services and who is responsible for his/her
care
* Know what member support services are available, including whether an
interpreter is available if he/she does not speak English
* Know what rules and regulations apply to his/her conduct
* Be given, upon request, full information and necessary counseling on
the availability of known financial resources for his/her care
* Receive, upon request, prior to treatment, a reasonable estimate of
charges for medical care and receive a copy of a reasonably clear and
understandable, itemized bill and, upon request, to have the charges explained
for services not covered by SHP
* Impartial access to medical treatment or accommodations, regardless of race,
national origin, religion, handicap, or source of payment
* Treatment for any emergency medical condition that will deteriorate from
failure to provide
treatment
* Be advised if medical treatment is for purposes of experimental research and
be able to give his/her consent or refusal to participate in such experimental
research
SHP Members are responsible for:
* Providing to the health care provider, to the best of their knowledge,
accurate and complete information about present complaints, past illnesses,
hospitalizations, medications, and other matters relating to their health
* Reporting unexpected changes in their condition to the health care
provider
* Reporting to the health care provider whether they comprehend a
contemplated course of action and what is expected of them
* Following the treatment plan recommended by the health care provider
* Keeping appointments and, when they are unable to do so for any reason,
for notifying the health care provider or health care facility
* Their actions if they refuse treatment or do not follow the health care
provider’s instructions
* Assuring that the financial obligations of their health care are
fulfilled as promptly as possible
* Following health care facility rules and regulations affecting patient
care and conduct
No comments:
Post a Comment