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HNE members have specific rights and responsibilities that form the basis of quality health care. We are pleased to share the HNE Members’ Rights and Responsibilities Statement, which tells you what you can expect from us and what we ask of you.
Your Rights
- To receive information on HNE, its services, plan providers, policies, procedures, and your rights and responsibilities. HNE will not release information that by law may not be given to members or any third party. We will not disclose privileged information about plan providers.
- To be treated with respect and with recognition of your dignity and right to privacy.
- To participate in health care decisions with your doctor or other health care provider.
- To expect that your doctor or other health care provider will fully and openly discuss appropriate, medically necessary treatment options, regardless of the cost or benefit coverage. It does not mean that HNE covers all treatment options. If you are unsure about coverage, please contact Member Services at 413.787.4004 or 800.842.4464.
- To contact us with a grievance or complaint about HNE or a plan provider. See your plan materials for instructions.
- To refuse a treatment, drug, or other procedure recommended by your doctor or other health care provider as the law allows. Providers should tell you about any potential medical effects of refusing treatment.
- To select a Primary Care Physician (PCP) who is accepting new patients. For a list of PCPs, search the Provider Directory on www.hne.com or call Member Services at 413.787.4004 or 800.310.2835.
- To change your PCP. You may choose any plan PCP, except those who have notified HNE that they no longer accept new patients.
- To have access, during HNE’s business hours, to Member Services Representatives who can answer your questions and help resolve problems.
- To expect that your medical records and information on your relationship with your doctor will remain confidential, in accordance with state and federal law and HNE policies.
- A right to make recommendations regarding HNE’s Member rights and responsibilities policies.
Your Responsibilities
- To provide, as much as possible, the information your providers need to care for you. This includes information on your present and past medical conditions, as you understand them, before and during any course of treatment.
- To follow the treatment plans and instructions for care that you have agreed on with your provider.
- To read HNE materials to become familiar with your benefits and services. If you have any questions, you should call Member Services at 413.787.4004 or 800.310.2835.
- To follow all HNE policies and procedures.
- To treat providers and HNE staff with the respect and courtesy that you would expect for yourself.
- To arrive on time for appointments or give proper notice if you must cancel or will be late.
- To understand your health problems, an important factor in your treatment. If you do not understand your illness or treatment, talk it over with your doctor.
- To participate in decision-making on your health care.
- To inform HNE of any other insurance coverage you may have. This helps us process claims and work with other payors.
- To notify us of status changes (such as a new address) that could affect your eligibility for coverage.
- To help HNE and plan providers get prior medical records as needed. You agree that HNE may obtain and use any of your medical records and other information needed to administer the plan.
- To consider the potential effects if you do not follow your provider’s advice. When a service recommended by a plan doctor is covered, you may choose to decline it for personal reasons. For example, you may prefer to get care from out-of-plan providers rather than plan providers. In these cases, HNE may not cover substitute or alternate care that you prefer.
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