BlueChoice HealthPlan

providers

Member Rights and Responsibilities

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Member Rights

  • Members have the right to be treated with respect and recognition of their dignity and right to privacy.
  • Members have the right to choose their own personal doctor from our list of health care professionals. If members are not happy with their first choice, they have the right to choose another primary care physician from our network.
  • Members have the right to expect their primary care physician and his team to coordinate all the care they need.
  • Members have the right to participate with their doctors in decision making to help take charge of their own health.
  • Members have the right to get the information they need to make a thoughtful choice before they take any treatment their doctor suggests. This includes information about the appropriateness or medical necessity of treatment options, regardless of cost or benefit coverage.
  • Members have the right to learn about their condition and treatment in words they understand and to be a part of decisions about their own care.
  • Members have the right to share their opinions, concerns or complaints constructively.
  • Members have the right to receive information about BlueChoice HealthPlan, our services, practitioners, providers and members' rights and responsibilities.
  • Members have the right to complain or make appeals about BlueChoice HealthPlan or the care they receive.
  • Members have the right to make recommendations regarding BlueChoice HealthPlan's rights and responsibilities policy.

 

Member Responsibilities

  • Members have the responsibility to treat all medical staff with respect and courtesy as their partners in good health.
  • Members have the responsibility to work with their doctor to form a good relationship based on trust and teamwork.
  • Members have the main responsibility of keeping up their good health and preventing illness.
  • Members have the responsibility to ask questions and make sure they understand the information they receive.
  • Members have the responsibility to give BlueChoice HealthPlan and their doctors as much information as they can so it can be used to help them get well.
  • Members have the responsibility to work with their primary care physician to form a treatment plan, and to follow the directions  agreed upon.
  • Members have the responsibility to think about what might happen if they don't follow their doctor's treatment plans or suggestions.
  • Members have the responsibility to keep appointments they schedule. In cases where they may have to cancel or may be running late, members have the responsibility to call the office and let them know.
  • Members have the responsibility to read all our materials carefully as soon as they sign up for BlueChoice HealthPlan. Members have the responsibility to follow the rules of their membership.

 

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