2013 Practitioner and Provider Manual - Presbyterian Healthcare ...

Presbyterian Customer Service CenterGet any information in a different format incompliance with the Americans withDisabilities Act.Members have the responsibility to:Give their complete health information. Thishelps their provider give them the care theyneed. This includes providing childhoodimmunization (shot) records for members upto age 21.Follow their treatment plans and instructionsfor medications, diet, and exercise as agreedupon by the member and their provider.Keep their appointment. If they cannot keep it,they should call their provider to reschedule orcancel no later than 24 hours before theappointment.Tell the provider if they do not understand hisor her explanation about their care. Ask theprovider questions. Talk to the PCSC aboutany suggestions or problems they may have.Respect providers and other health careemployees. Treat them with courtesy.Act in a way that supports the care otherpatients get. Act in a way that supports thegeneral functioning of the facility.Refuse to let any other person use theirPresbyterian member ID card.Tell Presbyterian right away if they lose theirmember ID card, or if it is stolen.Know what could happen if they givePresbyterian information that is wrong orincomplete.Tell the New Mexico HSD and Presbyterian.when their phone number, address, or familystatus changes.Tell their providers that they havePresbyterian, at the time of service. They mayhave to pay for services if they do not tell theirprovider that they have Presbyteriancoverage.Protect the privacy of their own care and ofother patients’ care.Ask about any arrangements Presbyterian haswith its providers. This applies to monetarypolicies that might limit referrals or treatment.It also applies to policies that might limitmember services.Change their PCP according to the rulesdescribed in the Member Handbook.Note: Members’ rights and responsibilities arealso available on our website athttp://www.phs.org, or a member may call thePCSC to request a printed copy.ConfidentialityPresbyterian is committed to protecting members’PHI and safeguarding confidential medicalinformation through the implementation of thePresbyterian confidentiality policy. For a printedcopy of the policy, please contact your providernetwork management relationship executive(http://docs.phs.org/idc/groups/public/%40phs/%40php/documents/phscontent/pel_00140718.pdf).Upon enrollment and annually thereafter,Presbyterian provides each member with a JointNotice of Privacy Practices. This notice describes19-72014 Practitioner and Provider Manual - Ver. 3