Patient Rights and Responsibilities
Patient Rights
Providence physicians are committed to partnering with you in maintaining
your good health. As a patient, you have the right to:
- Exercise these rights without regard to gender, sexual orientation or cultural,
economic, educational or religious background.
- Receive information about our Medical Group, its services, and health care
providers.
- Be treated with professionalism, respect, courtesy and dignity.
- Have all matters considered in privacy and confidentiality.
- Participate in decisions about your healthcare and treatment, as well as
receive adequate information about your diagnosis and proposed treatment
plan from your healthcare provider.
- A candid discussion of appropriate or medically necessary treatment options
for your condition, regardless of cost or benefit coverage.
- Refuse any procedure or treatment if you so desire and be told what effect
this may have on your health.
- Be informed of test results in a timely manner.
- Obtain a second opinion by another St. Joseph Heritage Medical Group provider.
- Have access to acute medical care twenty-four (24) hours a day, through
emergency room coverage, every day of the year if you have a life threatening
medical condition.
- Have the physician whom you visit focus his or her best efforts on your
behalf in order to make a diagnosis and develop a proposed treatment plan
based on the information available at the time of the visit.
- Receive complete information about our fees upon request.
- Right to voice complaints or appeals about the medical group or the care provided
- Knowledge that the Medical Group specifically does not reward practitioners
or other individuals conducting utilization review for issuing denials
of coverage, service or decisions that result in underutilization.
- Have the right to submit to the provider an amendment to the medical record
if upon review the patient believes any item or statement is incorrect
or incomplete.
- Right to be represented by parents, guardians, designated family members
or other conservators for those who are unable to fully participate in
their treatment decisions.
- Right to make recommendations regarding the Physician Group's Member
Rights and Responsibilities Policies.
Patient Responsibilities
Providence physicians are committed to partnering with you in maintaining
your good health. As a patient, you have the responsibility to:
- Provide your healthcare provider with complete and accurate information.
- Understand your health problems and participate in developing mutually
agreed upon treatment goals to the degree possible and notify him/her
of any significant changes in your condition.
- Recognize that your primary care physician will provide the care he or
she is trained to provide prior to seeking consultation with a specialist.
- Know the benefits, limitations and exclusions of your insurance coverage.
- Pay for services rendered, including co-payments and deductibles.
- Understand that before specialty care may be obtained, you must receive
a referral from your primary care physician, if required by your insurance company.
- Give adequate notice of delay or cancellation of scheduled appointments.
- Contact your primary care physician or substitute anytime for perceived
urgent medical needs or questions.
- Know how to access healthcare services for routine, urgent and emergency
situations. An emergency is a serious condition requiring immediate intervention.
An urgent condition could either lead to a potentially harmful outcome
if not treated or requires immediate attention (within 24 hours) due to
the severity of the symptoms. A non-urgent condition includes a limited
physical exam or follow-up of acute or chronic medical or surgical conditions.
- To designate a family member(s) or other conservator(s) if you are unable
to participate in treatment decisions.
Open Payment Notice
For informational purposes only, a link to the federal Centers for Medicare
and Medicaid Services (CMS) Open Payments web page is provided
here. The federal Physician Payments Sunshine Act requires that detailed information
about payment and other payments of value worth over ten dollars ($10)
from manufacturers of drugs, medical devices, and biologics to physicians
and teaching hospitals be made available to the public. Visit:
https://openpaymentsdata.cms.gov/