By Leah Grebner, MS, Director, Health Information Technology, Midstate College
When receiving health care services, there are certain rights and responsibilities that the patient should be aware of. In 2010, the Patient Bill of Rights and Responsibilities was updated from the previous version that was published in 1998. There are eight key areas addressed in this Consumer Bill of Rights and Responsibilities.
- Information for patients
- Choice of providers and plans
- Access to emergency services
- Taking part in treatment decisions
- Respect and non-discrimination
- Confidentiality (privacy) of health information
- Complaints and appeals
- Consumer responsibilities
Patients have the right to access information about their health plan and health care providers in a manner that is easy to understand. This includes accommodations for language barriers and other disabilities. If a decision needs to be made about a health care treatment, the patient must be provided with information about all known risks and benefits of the treatment, as well as the risks and benefits of not having the treatment. This is called “informed consent.” If a patient is provided with information and does not completely understand, the patient is responsible for asking questions to obtain clarification.
There a variety of options available for seeking treatment. Patients have the right to select where and from whom they receive treatment. Although insurance plans may have restrictions regarding which providers are in network, the patient still has the right to receive health care services from providers out of the network; however, it is important to recognize the fact that this freedom of choice may come at an additional charge if going out of network for treatment.
Access to emergency services is a right that all patients have at any time and from any provider. This is further supported by the Emergency Medical Treatment and Labor Act (EMTALA), which was passed in 1986. This act established that all patients have access to emergency services, no matter what their ability to pay is. This includes pregnant patients in active labor.
Patients have the right to be actively involved in decisions regarding their health care. This includes the right to know not only about their medical conditions, but also about all treatment options and the right to refuse medical treatment. If a patient is incapable of making sound decisions, they may designate an individual to make decisions for them through power of attorney for health care services.
Health care providers must be considerate and respectful when delivering health care services without discrimination. Patients also have the right to make complaints with fair, prompt, and objective review. These complaints may involve any aspect of the health care services provided, including issues such as time spent waiting or limited office hours. Just as the patient has the right to receive respect from health care providers, the patient, likewise, has the responsibility of providing respect and consideration toward health care providers. An additional form of respect and consideration responsible by the patient is timely payment of medical bills and compliance with terms of their health plans.
Patients have the right for confidential, private communication with health care providers. Additionally, this right includes the right to review the patient’s own health record. HIPAA includes a provision that the patient may request an amendment to their health record in the case that documentation is found to be incorrect.
In addition to the rights that patients may appreciate related to health care, there are also responsibilities that the patients must uphold. Patients must honestly and completely communicate information that they have related to their health, including any medications or medical conditions. This includes provision of past medical history. Patients have the responsibility of posing questions to health care providers to receive additional information or detail to facilitate understanding.
In order to facilitate the effectiveness of health care, patients have the responsibility of living in a manner that will improve their health. This not only means following instructions given by a health care provider, but it also includes making healthy lifestyle choices, such as smoking cessation, following a healthy diet, and exercising. Living a healthy lifestyle and compliance with treatment plans has the potential to help contain costs of care at many levels, as unnecessary additional care may be avoided.
For additional information, please contact Dr. Leah Grebner, MS, RHIA, CCS, FAHIMA. Looking to change your career? Visit Midstate College, www.midstate.edu or call 309-692-4092. Midstate College is located at 411 West Northmoor Road, Peoria, IL 61614.