KNOW YOUR RIGHTS
As a Patient, you have the right to:
• Considerate, respectful care at all times and under all circumstances with recognition of your personal dignity and property.
• Information concerning your diagnosis, evaluation, treatment, and prognosis, to the degree known.
• Confidentiality of records and disclosures. Except when required by law, you have the right to approve or refuse the release of records. Personal and informational privacy will be respected.
• The opportunity to participate in decisions involving your health care by you and significant others, unless contraindicated by concerns for your health.
• Make informed decisions about medical care, including the right to accept or refuse medical or surgical treatment. Know that there may be a modification to an existing living will or DNR directive. If you would like information about advanced directives, please speak with a nurse.
• Information concerning: patient conduct and responsibilities; services available at the organization, provisions for after-hours and emergency care; fees for services, payment policies, implementation of any advance care directive.
• Impartial access to treatment regardless of race, color, sex, national origin, religion, handicap, disability or ability to pay. (Digestive Health Specialists, P.A. adheres to all federal and state rules, regulations and policies to promote a non-discriminatory environment for all of our guests.)
• Receive an explanation of charges for services delivered.
• Know the identity and professional status of individuals providing service to you.
• Report any comments concerning the quality of services provided to you during the time spent at the facility and receive fair follow-up on your comments. Grievances can be reported to management at 336-768-6211. If we are unable to satisfactorily address your complaint, you may contact the Department of Health and Human Services at 2001 Mail Service Center, Raleigh, NC 27699 or by phone at 1-919-855-4800 and/or the NC Medical Board by mail at PO BOX 20007, Raleigh, NC 27619 or by phone at 1-800-253-9653. You may also contact the Office of the Medicare Beneficiary Ombudsman at 1-800-MEDICARE http://www.cms.hhs.gov/center/ombudsman.asp
• Change primary or specialty physicians if other qualified physicians are available.
• Know that Digestive Health Specialists Ambulatory Surgical Center and Digestive Health Specialists
Pathology Laboratory is owned and operated by the Physicians of Digestive Health Specialists, P.A.
• Exercise these rights without being subject to discrimination or reprisal.
• Receive care in a safe setting and be free from all forms of abuse or harassment.
Patient Responsibilities – You agree to…
• Providing, to the best of your knowledge, accurate and complete information about your present health status and past medical history and reporting any unexpected changes to the appropriate practitioner(s).
• Following the treatment plan recommended by the primary practitioner involved in your case.
• Providing an adult to transport you home after procedures requiring sedation.
• Indicating whether you clearly understand a contemplated course of action and what is expected of you.
• Your actions if you refuse treatment, leave the facility against the advice of the practitioner, and/or do not follow the practitioner’s instructions relating to your case.
• Assuring that the financial obligations of your health care are fulfilled as expediently as possible, including accepting personal financial responsibility for any charges not covered by your insurance.
• Providing information about a durable power of attorney directive that you desire us to know about.
• Being respectful of all health care providers and staff, as well as other patients.
• Notifying us of changes regarding your demographics info and/or insurance coverage.
• Sharing any values, beliefs, traditions which would help the staff provide appropriate care.
• Following facility policy and procedures.
• Keeping your appointments and being on time. If you cannot keep a scheduled visit, please call us at once and reschedule or cancel so another patient can use that time.