Member Rights and Responsibilities
At FHN, we want to make sure our members get the health care they need. We also want to make sure their rights as a member are respected.
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.
FHN 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.