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.