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Member Rights and Responsibilities
- You have the right to receive information about Beacon’s services, benefits, practitioners,
providers, member rights and responsibilities and clinical guidelines.
- You have the right to be treated with respect as an individual in a manner that
protects your privacy and dignity, regardless of race, gender, veteran status, religion,
marital status, national origin, physical disabilities, mental disabilities, age,
sexual orientation, or ancestry.
- You have the right to have all communication regarding your health information kept
confidential by Beacon staff and contracted providers and practitioners, to the
extent required by law.
- You have the right to participate with practitioners and providers in your own treatment
planning and decision making regarding your care, and to include family members
when appropriate and/or requested. Treatment planning discussions may include all
appropriate and medically necessary treatment options, regardless of benefit design
and/or cost implications.
- You have the right to give or refuse consent for treatment and give or refuse consent
for communication of treatment information to your PCP and/or other behavioral health
providers.
- You have the right to obtain information regarding your own treatment record with
signed consent.
- You have the right to appeal a Beacon Health Strategies authorization decision resulting
in denial of any aspect of care or service.
- You have the right to submit a complaint or concern (or have a designee do so on
your behalf), verbally or in writing, about the care you have received.
- You have the right to contact Beacon’s Office of Ombudsman to obtain a copy of Beacon’s
member rights and responsibilities statement. You may make recommendations about
the member rights and responsibilities statement to the Ombudsperson.
- You have the right to participate in the Member Advisory Council. You may make recommendations
about the member rights and responsibilities statement to the council.
Member Responsibilities
- You are responsible for choosing a primary care provider and site for the coordination
of all your medical care.
- You are responsible for carrying your Managed Care Organization (Health Plan/MCO)
member ID card and showing the card whenever you seek treatment.
- You are responsible for providing information, to the best of your ability, to Beacon
and treating providers that is necessary to ensure effective behavioral healthcare
for you.
- You are responsible, to the best of your ability, to understand your behavioral
healthcare needs and participate in your treatment including developing, following
and revising as necessary, mutually agreed upon treatment and aftercare plans.
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