Patient Rights & Responsibilities

The patient has the right to:

1. Receive services without regard to age, race, color, sexual orientation, religion, marital status, sex, national origin, or sponsor in a safe setting free of all forms of harassment and or abuse.

2. Be treated with consideration, respect and dignity including personal privacy in treatment.

3. Be informed of the services available and applicable charges at the Center.

4. Be informed of the provisions for after hours and emergency care.

5. Be informed of the charges for services, eligibility for third-party reimbursements and, when applicable, the availability of free or reduced cost care.

6. Receive an itemized copy of his/her account statement, upon request.

7. Obtain from his/her Health Care Provider, or the Health Care Practitioner’s delegate, complete and current information concerning his/her diagnosis, treatment, and prognosis in terms the patient can be reasonably expected to understand.

8. Receive from his/her physician information necessary to give informed consent prior to the start of any nonemergency procedure or treatment or both. An informed consent shall include, as a minimum, the provision of information concerning the specific procedure or treatment or both, the reasonably foreseeable risks involved, and alternatives for care or treatment, if any, as a reasonable medical practitioner under similar circumstances would disclose in a manner permitting the patient to make a knowledgeable decision; Refuse treatment to the extent permitted by law and to be fully informed of the medical consequences of his/her action.

9. Refuse treatment to the extent permitted by law and to be fully informed of the medical consequences of his/her action.

10. Refuse to participate in experimental treatment/research.

11. Voice grievances and recommend changes in policies and services to the Center’s staff, The Operator and the New York State Department of Health without fear of reprisal.

12. Express complaints about the care and services provided and to have the Center investigate such complaints. The center is responsible for providing the patient or his/her designee with a written response within 30 days if requested by the patient indicating the findings of the investigation. The center is also responsible for notifying the patient or his/her designee that if the patient is not satisfied by the center response, If the patient is not satisfied by the Center’s response, the patient may complain to the Administrator at 212.889.5477, AAAHC 5250 Old Orchard Rd, Ste 200 Skokie, IL 60077 P. 847-853-6060 or [email protected], New York State Department of Health’s Metropolitan Area Regional Office (MARO) at 800 804-5447 or the Office of the Medicare Beneficiary Ombudsman Visit www.medicare.gov or call 1.800.MEDICARE (1.800.633.4227) or use http://www.medicare.gov/claims-and-appeals/medicare-rights/get-help/ombudsman.html

13. Privacy and confidentiality of all information and records pertaining to the patient’s treatment.

14. Approve or refuse the release or disclosure of the contents of his/her medical record to any Health Care Practitioner and/or Health Care Facility except as required by law or third-party payment contract.

15. Access to his/her medical record per Section 18 of the Public Health Law, and Subpart 50-3. For additional information link to: http://www.health.ny.gov/publications/1449/section_1.htm#access

16. Authorize those family members and other adults who will be given priority to visit consistent with your ability to receive visitors; and

17. When applicable, make known your wishes regarding anatomical gifts. Persons sixteen years of age or older may document their consent to donate their organs, eyes and/or tissues, upon their death, by enrolling in the NYS Donate Life Registry or by documenting their authorization for organ and/or tissue donation in writing in several ways (such as health care proxy, will, donor card, or other signed paper). The health care proxy is available from the center. To Execute an Advance Directive and/or Health Care Proxy

18. View a list of the health plans and the hospitals that the Center participates with; and receive an estimate of the amount that you will be billed after services are rendered.

19. If a patient is adjudged incompetent under applicable State laws by a court of proper jurisdiction, the rights of the patient are exercised by the person appointed under State law to act on the patient’s behalf.

The patient has the following responsibilities:

20. To provide the Center with complete and accurate information to the best of his/her ability about his/her health, any medications, including over the counter products and dietary supplements and allergies or sensitivities.

21. To ask all questions you may have regarding the treatment provided by the Center.

22. Provide a responsible adult to transport him/her home from the Center and if required by his/her provider, remain with him/her for 24 hours.

23. To consent by free will to all procedures.

24. Inform his/her provider about any living will, medical power of attorney, or other directive that could affect his/her care.

25. To tell us if you do not understand procedures or instructions.

26. To follow after-care instructions as recommended by the Center.

27. To contact his/her Physician with post-testing questions or concerns.

28. To provide all necessary information regarding third-party payment sources.

29. Accept personal financial responsibility for any charges not covered by his/her insurance.

30. To observe all the Center’s Policies and Safety Regulations.

31. To keep appointments as scheduled or advise the Center if the appointment cannot be kept.

32. To be considerate of other Patients and Personnel and respect the property of others and the Center.