To be treated with respect and dignity;
To receive advice or assistance in a prompt, courteous and responsible manner;
To choose a physician among those contracted with the plan. Members are asked to establish an ongoing relationship with their physicians. Maintaining this relationship is an important part of their healthcare. Members also have the right to change physicians if they so desire;
To confidentiality. All information concerning their enrollment and medical history is privileged and confidential except when disclosure is required by law or permitted in writing by the member. Members are entitled access to their medical records according to state and federal law; and, with adequate notice, members have the right to review their medical records with their physician;
To information about their diagnosis, treatments and expected outcomes in terms the member understands. If the provider determines that the information could be detrimental to the member, the information is given to a person the member designates or someone with legal authority;
To information about the healthcare plan, the network physicians, and other healthcare providers providing their care;
To discuss healthcare concerns or complaints about MHP with those responsible for the member’s care or with MHP;
To participate in decisions about the kind of care they want or do not want. Members should receive enough information to enable them to make an informed decision before they receive any recommended treatment. The information should include the specific procedure or treatment, medical alternatives, and associated risks;
To have a guardian, next of kin, or legally authorized person exercise their rights if the members’ medical condition makes them incapable of understanding or exercising their rights;
To receive information about the managed care organization, its services, its practitioners and providers, and members’ rights and responsibilities;
To participate with practitioners in decision-making regarding the member’s healthcare;
To a candid discussion of appropriate or medically necessary treatment options for their condition, regardless of cost or benefit coverage;
To voice complaints or appeals about the managed care organization or the care provided;
To a copy of their medical records. Members are guaranteed the right to request and receive a copy of their medical records, and to request amendments or corrections; and
To be free to exercise rights. Members are free to exercise their rights, and that the exercise of those rights does not adversely affect the way the health plan, its providers, or the state agency, treat members.
To treat all MHP and provider network personnel and other members with respect and courtesy;
To provide, to the best of their knowledge, honest and complete information about matters relating to their health. If members do not understand, have questions, or disagree with the treatment plan, they have the responsibility to discuss their concerns with the treatment staff and make certain they understand the explanations and instructions;
To carry their identification cards at all times and never permit anyone else to use them;
To provide, to the extent possible, information that the managed care organization and its practitioners and providers need in order to care for them;
To follow the plans and instructions for care that they have agreed upon with their practitioners;
To be on time for appointments and notify the physician’s office promptly if they cannot keep an appointment;
To pay applicable co-payments and to notify MHP of any additional sources of insurance coverage or reimbursement (e.g., Workers’ Compensation and others);
To notify their employer and MHP of address changes or changes in family status affecting eligibility or enrollment (e.g., marriage, birth, adoption, divorce, death or guardianship); and
To express their opinions, concerns, or complaints in a constructive manner as outlined in the member handbook to the appropriate people within MHP or the MHP network. Member Services Representatives are available Monday through Friday.