SelectHealth | Total Fitness | Winter 2016

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As a SelectHealth member, 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 do the following:
• 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
about your health so you can make
Your rights and
responsibilities
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
orientation—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 do
the following:
• 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 you have 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 | Winter 2016 |
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