Respectful and courteous treatment. You have the right to be treated with respect, dignity and courtesy by IEHP providers and staff. You have the right to be free from retaliation or force of any kind when making decisions about your care. You have the right to be free from restraint (including physical and mechanical restraints and drugs), used as a means of coercion, discipline, convenience, or retaliation.
Privacy and confidentiality. You have a right to have a private relationship with your provider and to have your medical record kept confidential. You also have a right to get a copy of and request corrections to your medical record. If you are a minor, you have a right to some services that do not need your parent’s consent.
Choice and involvement in Your care. You have the right to get information about IEHP, its services, its doctors, and other providers. You have the right to choose your Primary Care Physician (doctor) from the doctors and clinics listed in IEHP’s website or provider directory. You also have the right to get appointments within a reasonable amount of time. You have a right to talk with your doctor about any care your doctor provides or recommends. You have the right to a second opinion. You have a right to information about treatment regardless of the cost or what your benefits are. You have the right to say “no” to treatment. You have a right to decide in advance how you want to be cared for in case You have a life-threatening illness or injury.
Get Timely Customer Service. You have the right to wait no more than 10 minutes to speak to a representative during IEHP’s normal business hours.
Voice Your concerns. You have the right to complain about IEHP, our providers, or the care you get without fear of losing your benefits. IEHP will help you with the process. If you do not agree with a decision, you have a right to ask for a review. You have a right to disenroll from IEHP whenever you want.
File a grievance in Your preferred language by using the interpreter service or by completing the translated grievance form that is available on www.iehp.org.
Service outside of IEHP’s provider network. You have a right to get emergency, urgent care while out of the service area, and or services in certain facilities when authorized by IEHP, outside IEHP’s provider network. You have the right to get emergency treatment whenever and wherever you need it. If you get emergency care outside of the United States, you have a right to be reimbursed for the cost of emergency services up to at the maximum Allowable Amount.
Service and information in Your language. You have the right to request an interpreter at no charge instead of using a family member or friend to interpret for you. You should not use children to interpret for you. You have the right to request other member materials in a language or format (such as large print or audio you understand.
Know Your rights. You have the right to get information about your rights and responsibilities. You have the right to make recommendations about these rights and responsibilities.
As a Member of IEHP, you have a responsibility to:
Act courteously and respectfully. You are responsible for treating your IEHP doctor and all our providers and staff with courtesy and respect. You are responsible for being on time for your visits or calling your doctor’s office at least 24 hours before the visit to cancel or reschedule.
Give up-to-date, accurate and complete information. You are responsible for giving correct information that IEHP and your providers need in order to provide care. You are responsible for getting regular checkups and telling your doctor about health problems before they become serious. You are responsible for notifying IEHP as soon as you can if you are billed by mistake by a provider.
Follow Your Primary Care doctor’s advice and take part in Your care. You are responsible for selecting a Primary Care doctor or accept the Primary Care doctor that IEHP will assign to you. You are responsible for talking over your health care needs with your Primary Care doctor, developing and agreeing on goals, doing your best to understand your health problems, and following the treatment you both agree on.
Use the Emergency Room only in an emergency. You are responsible for using the emergency room in cases of an emergency or as directed by your doctor or IEHP’s 24-hour, free nurse advice line. If you are not sure you have an emergency, you can call your doctor or call IEHP’s Free 24-Hour Nurse Advice Line at 1-888-244-4347 (TTY 711).
Report wrongdoing. You are responsible for reporting health care fraud or wrongdoing to IEHP. You can report without giving your name by calling the IEHP Compliance Helpline toll-free at 1-866-355-9038.