Patient rights and responsibilities

As a patient, you have the right to:

• have your personal dignity respected.
• the confidentiality of your identifiable health information.
• enjoy personal privacy and a safe environment.
• have your cultural, psychosocial, spiritual, and personal values, beliefs, and preferences respected.
• receive care regardless of your age, race, color, national origin, culture, ethnicity, language, socioeconomic status, religion, physical or mental disability, sex, sexual orientation, or gender identity or expression, or manner of payment.
• make advanced directives and have them followed.
• know the rules regulating your care and conduct.
• be informed and involved in decisions that affect your care, health status, services or treatment.
• understand your diagnosis, condition and treatment and make informed decisions about your care after being advised of material risks, benefits and alternatives.
• knowledgably refuse any care, treatment, and services.
• receive information you can understand.
• ask for, and be granted a change of provider or a second opinion.
• request a listing of disclosures about your health care, and to be able to access and request to amend your medical record as allowed by law.

As a patient, it is your responsibility to:

• give Prevea complete and accurate information about your health, including your previous medical history and all the medications you are taking.
• inform Prevea of any changes in your medical conditions or symptoms.
• provide Prevea with your advanced directives.
• provide correct contact information so we may reach you if needed.
• let Prevea know if you don’t understand the information we give you about your condition or treatment.
• follow Prevea’s instructions and advice, understanding that you must accept the consequences if you refuse.
• pay your bills or make arrangements to meet the financial obligations arising from your care and to provide correct and updated insurance information.
• be considerate and cooperative.
• respect the rights of others.

Complaints

Any patient/family member may file a complaint with a staff member of Prevea Health. The complainant will be offered a formal or informal resolution process. This process should be initiated within 30 days of the incident. Immediate resolution will be attempted in the department where it is identified, in an informal manner.

Formal Complaints

If resolution cannot be immediately achieved, the complainant may request a formal process.

To initiate the formal complaint process, the complainant may complete the concern form in the department, through the “Contact Us” section on prevea.com, or call Prevea Health at (920) 496-4700 and ask for the Office of Quality Resources.

If the formal complaint is not filed in person, the complainant can expect to receive a call within five working days from a staff member of Quality Resources, and a resolution within two to four weeks.

During the complaint process, it is your right to:

• receive a reasonably prompt response to your request for services.
• be involved in resolving issues involving your own care, treatment, or services.
• not be limited to the number of complaints you may file.
• not be subjected to any form of retribution for filing a complaint.

You can file a grievance in person or by mail, fax or email. If you need help filing a grievance, Compliance Officer and 1557 Coordinator is available to help you. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights electronically through the Office for Civil Rights Complaint Portal, available here, or by mail or phone at:

U.S. Department of Health and Human Services
200 Independence Avenue SW
Room 509F, HHH Building
Washington, DC 20201

Complaint forms are available here.

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