Member Rights and Responsibilities

At FHN, we want to make sure you and your family get the health care you need. We also want to make sure your rights as a member are respected.

Rights

FHN Members have the right to:

  • Receive the Member Rights and Responsibilities statement.
  • Receive information about FHN, its services and providers.
  • Be treated with respect and recognition with due consideration for the member’s dignity and right to privacy.
  • Participate in decisions with practitioners regarding the member’s health care, including the right to refuse treatment.
  • Have an open conversation of appropriate or necessary medical treatment choices for their conditions, regardless of the cost or benefit coverage.
  • Make a complaint, appeal or file a grievance to FHN, about the organization or the care it provides.
  • Make recommendations regarding the organization’s member rights and responsibilities policy.
  • Receive information on available treatment options and alternatives, and presented in a manner appropriate to the member’s condition and ability to understand.
  • Be free from any form of restraint or seclusion used as a means of coercion, discipline, convenience or retaliation.
  • Request and receive a copy of the member’s medical records, and to request that they be amended or corrected.
  • Exercise the member’s rights, and that the exercise of those rights will not adversely affect the way the member is treated.
  • Receive care consistent with sound nursing and medical practices, have candid discussion of appropriate or medically necessary treatment options for their conditions, regardless of cost or benefit coverage.
  • Share in deciding the type of care they will receive. Persons under the age of 18 who are married, pregnant or have a child, also have this right.
  • Request information regarding MCO and health care facility licensure.
  • Request information about providers of health care services, including education, board certification, and re-certification.
  • Request information regarding provider bills and payments.
  • Make a “living will” to plan for the kind of care they want if they become seriously ill or injured.
  • Expect their records to be treated confidentially and to not be released without their permission.
  • Choose a family doctor from FHN and to switch to another FHN doctor at any time.
  • Not be terminated from FHN due to high utilization of services, diminished mental capacity or uncooperative/disruptive behavior resulting from the member’s special needs.

Responsibilities

Members and/or their Enrolled Dependents have the responsibility to:

  • Supply information to the extent possible that FHN and our doctors need to provide care.
  • Follow their doctor’s treatment plan and instructions for care that they have agreed to with their doctors.
  • Understand their specific health problems while being able to participate in developing a mutually agreed-upon treatment goal that is possible.
  • Treat doctors, staff and FHN employees with dignity and respect.
  • Make and keep appointments and be on time. A member will always call with as much notice as possible if he/she needs to cancel an appointment or if he/she will be late.
  • Get referrals from their doctor before going to a specialist, hospital or another health care provider.
  • Notify their FHN doctor as soon as possible after receiving emergency room services.
  • Explain their health problem and symptoms to the doctor and to ask questions.
  • Discuss with their FHN doctor any circumstances that could prevent them from following doctor’s instructions.
  • Become involved in their health care – get the information they need and take part in any treatment decisions.
  • Consider the outcome of refusing treatment recommended by a doctor.
  • Learn and follow the FHN policies in their Member Handbook.
  • Carry their FHN identification card with them at all times and immediately report any lost or stolen cards to one of the FHN Member Services representatives.
  • Call one of the FHN Member Services representatives if they have a problem and need help.
  • Respect the privacy of other people waiting to get health care services.
  • Make a “living will” to indicate their wishes concerning the type of care they want if they become seriously ill or injured.

Attention ProvidersBehavioral Health

Important updates about behavioral health services that will impact providers. Effective June 1, 2016, FHN will contract with Behavior Health Specialist directly. Click below for more information

 Provider Notice                                              FAQs        

Member Services

If you have a question about your health plan, please call Member Services.  Hours are 8 a.m. to 5 p.m. Monday through Friday and 9 a.m. to 1 p.m. Saturday.


Si tiene preguntas sobre su plan de salud, por favor llame a la línea de Atención a Miembros Participantes. Horario de 8 a.m. a 5 p.m. de Lunes a Viernes y Sábado de 9 a.m. a 1 p.m.

1-888-FHN-4YOU
(346-4968)
TTY: 711

FLU Season

Flu season begins in October and lasts as late as May. Talk to your doctor about getting a FREE flu shot today.

Click here for more information

Service Area

FHN serves people living in the Chicago area: including Cook, DuPage, Kane, Kankakee, Lake and Will Counties.

Service outside of our Service Area

If you are not in our service area and you need care but it is not an emergency, please call us at 1-888-346-4968 TTY: 711. We will work with you to help you get the care and services you need. When FHN helps to arrange non-emergency services for you outside its service area, we will cover the cost. If you get services outside of our coverage area, we may not pay for those services.
If you are not in our service area and you need emergency care, call 911 or go to the nearest hospital.