At a time when denials of care seem more important than the delivery of care, EC Medical Center places the needs of our patients first and foremost. To make sure we’re clear on that subject, we’ve developed our own Patients’ Bill of Rights.
- Be treated without regard to race, ethnicity, national origin, religion, sex, age, mental or physical disability, sexual orientation, genetic information or source of payment.
- Be treated in a manner respectful to your personal privacy and dignity.
- Receive assistance in a prompt, courteous and responsible manner.
- Receive a list of participating providers.
- Select a primary care provider (PCP) or change your PCP, if necessary.
- Knowledge of the name of the physician who has primary responsibility for coordinating your care and the names and professional relationships of other physicians who will see you.
- Be informed by your treating provider of your diagnosis, prognosis and treatment options in terms you understand, and regardless of cost or benefit coverage.
- Participate in decisions regarding medical care; be advised by your treating provider of the possible consequences of your decisions and refusing treatment.
- Have no restrictions placed on any provider that precluded discussing appropriate treatment options with you. Utilization Management (UM) decisions is based on the appropriateness of care and service required for each patient’s individual needs. We do not compensate nor give incentives to physicians, UM staff or clinic personnel for the denial of service or care.
- Requests for coverage of services are reviewed to determine that the service is a covered benefit under the terms of the member’s plan and that the service delivered is consistent with established guidelines. In the event a request for coverage is denied, the member, or a provider acting on behalf of the member, may appeal this decision through the grievance process and, depending on the specific circumstances, to an external utilization review organization, which uses independent physician reviewers, a governmental agency or the plan sponsor.
- Be advised if a physician proposes to engage in or perform human experimentation affecting your care or treatment. The patient has the right to refuse to participate in such research projects.
- Be referred, according to your needs, to a provider suitable to care for your condition.
- Be assured of confidential handling of all communication and medical information as provided by law and professional medical ethics.
- Express concerns including quality of care issues, receiving a response in a timely manner and initiating the grievance procedure through your health plan if you are not satisfied with our resolution of your complaint.
- Receive information about the clinic, its services, practitioners and providers, and patient’s rights and responsibilities.
- Make recommendations regarding this patient rights and responsibilities policy.