Purpose:

To promote effective health care, ConnectCare is committed to maintaining a mutually respectful relationship with enrollees. A statement of enrollees' rights recognizes the specific needs of enrollees, including the right to privacy and the right to be treated with dignity when receiving health care.

Procedure:

ConnectCare is committed to treating enrollees in manner that respects their rights and recognizes their responsibilities. A hard copy of this information is available upon request.

An enrollee has a right to:

• Be treated with respect and without discrimination
• Dignity and privacy
• Confidentiality and privacy regarding medical records and health information
• Prompt access to quality health care services
• Have a candid discussion of appropriate or medically necessary treatment options for their conditions, regardless of cost or benefit coverage
• Participate in decisions regarding his/her health care
• Refuse treatment and to be informed of the consequences of doing so
• Review test or exam results and to have them explained in understandable language
• Obtain copies of medical records upon request and payment of a fee
• Express complaints and/or make appeals regarding medical care or ConnectCare
• Receive information about ConnectCare, its services, practitioners and providers, and enrollee rights and responsibilities
• Make recommendations regarding ConnectCare's enrollee rights and responsibilities policies

An enrollee has a responsibility to:

• supply information needed by ConnectCare, practitioners and providers in order to provide care
• Be on time for appointments and to provide notice of appointment cancellations
• Pay applicable co-payments at time of service
• Follow prescribed treatment, advice, and instructions agreed upon with providers and/or practitioners, asking for clarification when needed
• Provide accurate and complete information regarding medical history and current problems
• Be familiar with his/her health care plan and to adhere to its requirements
• Notify the plan of changes in address, phone number, job status, family size or other factors affecting eligibility
• Be an informed consumer of healthcare and to assume responsibility for his/her health
• Understand his/her health problems and participate in developing mutually agreed upon treatment goals to the degree possible
• Assume responsibility for his/her actions if the member refuses treatment and does not follow the provider's instructions