ABHA PROVIDER MANUAL

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ABHA PROVIDER MANUAL | Contents | Overview | Access To Care | Contracting / Credentialing | Utilization Management | Member Rights / Grievances | Quality Assurance | Billing | Page Title

7

MEMBER RIGHTS & RESPONSIBILITIES

 

ABHA Members Have the Following Rights:

¨        The right to be treated with respect by your provider.

¨        The right to receive proper mental healthcare services.

¨        The right to be given information about your illness.

¨        The right to be told about the care to be given and make a decision about that care.

¨        The right to refuse care and be told what that means to your health.

¨        The right to be informed about your right to sign a declaration for mental health treatment.

¨        The right to get a copy of your clinical record unless restricted by law.

¨        The right to request a correction of your clinical record.

¨        The right to talk to your provider and expect that what you say will be kept private.

¨        The right to help us refer you to a mental health provider.

¨        The right to change your primary mental health provider for a good reason.

¨        The right to get our services without a referral from your doctor.

¨        The right to get care without being treated differently than other people.

¨        The right to get mental health care without a long delay.

¨        The right to receive information about all mental health services covered by the Oregon Health Plan (Medicaid).

¨        The right to get a written notice when we deny or change services.

¨        The right to make a complaint about us, or one of our providers, and receive a timely answer.

¨        The right to request an Administrative Hearing.

¨        The right to continue services until a decision about your Hearing is made.  You may have to repay these continued services if the hearing is resolved in ABHA’s favor.

¨        The right to receive, within 30 days of becoming an ABHA member, the following written documents:

·          Rights and responsibilities

·          Benefits available

·          How to access Covered Services

·          What to do in an emergency situation

·          How to make a complaint

¨        The right to get information in a form you can read and to have us explain them if needed.

¨        The right to access Protective Services as provided by state law.

¨        The right to be treated with respect by your provider.

¨        The right, if hospitalized, to be free from any form of restraint or seclusion as outlined by Federal law.

¨        The right to carry out your rights without your actions affecting the way ABHA and its Providers treat you.

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