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/