As a member of a SelectHealth plan, you
have the right to privacy and a high level
of medical care and customer service.
You are also responsible for following our
guidelines and making informed decisions
about your medical care. Suggestions
regarding policies and services are always
welcome. Call Member Services or submit
your comments in writing.
YOUR RIGHTS
You have the right to:
•
Review and obtain a copy of your
policy and member records, subject
to state law, and our policies
and procedures
•
Receive information about our
services, providers, and your member
rights and responsibilities
•
Receive considerate, courteous
care and treatment with respect for
personal privacy and dignity
•
Receive accurate information
regarding your rights and
responsibilities and benefits in
member materials and through
phone calls
•
Be informed by your provider
Your rights and
responsibilities
about your health so you can make
thoughtful decisions before you
receive treatment
•
Candidly discuss with your
healthcare provider appropriate
or medically necessary treatment
options for your condition,
regardless of cost or benefit coverage
(we do not have policies that restrict
dialogue between providers and
patients, and we do not direct
providers to restrict information
regarding treatment options)
•
Participate with providers in
decisions involving your health and
the medical care you receive
•
Express concerns about SelectHealth
and the care we provide and receive a
response in a reasonable period of time
•
Request a second opinion
•
Refuse recommended medical
treatment to the extent permitted
by law
•
Select or change your primary
care provider
•
Make recommendations
regarding our Member Rights and
Responsibilities policy
•
Have reasonable access to appropriate
medical services, regardless of your
race, religion, nationality, disability,
sex, or sexual preference and 24-hour
access to urgent and emergency care
•
Receive care provided by or referred
by your primary care provider
•
Have all medical records and other
information kept confidential
•
Have all claims paid accurately and in
a timely manner
YOUR RESPONSIBILITIES
You have the responsibility to:
•
Treat all providers and personnel at
SelectHealth courteously
•
Read all plan materials carefully as
soon as you enroll, understand your
plan benefits and limitations, and ask
questions when necessary
•
Understand that not all recommended
medical treatment is eligible for coverage
•
Follow plans and instructions for
care that have been agreed upon with
your provider
•
Express constructively your opinions,
concerns, and complaints to the
appropriate SelectHealth staff
•
Follow the policies and procedures
of your plan, and when appropriate,
seek a referral from your primary care
provider to SelectHealth providers or
call us for assistance
•
Ask questions and understand
the consequences of refusing
medical treatment
•
Communicate openly with your
healthcare provider, develop a patient/
provider relationship based on trust
and cooperation, and participate in
developing mutually agreed-upon
treatment goals
•
Keep scheduled appointments or give
adequate notice of cancellation
•
Obtain services consistently according
to the policies and procedures of
your plan
•
Provide all information needed by your
provider to assess your condition and
recommend treatment
•
Use our providers when applicable,
carry your ID Card, and pay copay/
coinsurance amounts at the time
of service
Total Fitness | spring 2014 |
selecthealth.org
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