Patient Rights and Responsibilities
As a Carelon Health patient, you have rights and responsibilities when receiving care. As your healthcare team, we want to make sure your rights are respected. That means giving you access to our network of healthcare providers and giving you the information you need to make the best decisions for your health. As a patient, you should also take an active role in your care.
You have the right to:
- Be treated with respect and dignity.
- Be safe from discrimination based on race, ability, religion, gender, sexual orientation, health, ethnicity, beliefs, age, or national origin.
- Get healthcare services in your preferred spoken or written language or an alternative format you understand.
- Speak freely and privately with your care team about all care options and treatments needed, no matter what the cost or whether it is covered by Carelon Health.
- Get the most up-to-date information from a healthcare provider about the cause of your illness, your treatment, and what may result from it. You can ask for help if you do not understand the information given to you.
- Work with your doctors to make decisions about your care.
- Share your feedback.
- Get a copy of your medical record if you request it.
- Have your health information kept private as described in our privacy policy and as described in state and federal laws.
- Say “no” to care for any condition, sickness, or disease without having it affect any care you may receive in the future. This includes asking your healthcare provider to tell you how that may affect your health, now and in the future.
- Get the information you need to make sure you get the most from your healthcare. This includes information about:
- Our company’s programs and services.
- How to opt in or out of programs.
- Our network of healthcare providers.
- How to make a complaint or file an appeal.
You have the responsibility to:
- Read all the information about your health benefits and ask for help if you have questions.
- Follow all rules and policies.
- Refrain from taking photos, videos, or any other recordings in a Carelon Health Care Center unless you have been given permission to do so for a care-related purpose.
- Treat all doctors and other healthcare providers and staff with respect.
- Keep all scheduled appointments and call your healthcare provider’s office if you may be late or need to cancel.
- Understand your healthcare needs as well as you can and work with your healthcare providers to make a care plan that you all agree on.
- Ask your healthcare provider for more information if you do not understand the type of care you are receiving or what you are supposed to do.
- Follow the care plan that you have agreed upon with your healthcare provider.
- Go to the emergency room only in the case of true emergencies or as directed by your healthcare provider.
- Tell healthcare providers you are a part of Carelon Health. Present your membership card before receiving care.
- Give healthcare providers all the information needed so they can help you get the best care possible. This may include information about other health insurance benefits you have in addition to coverage from us.
- Make copayments for your covered services and payments for services that are not covered.
- Call the Member Services number on the back of your health plan member ID card if you have any changes to your name, address, or telephone number.
- For Advanced Primary Care patients in applicable Medicare Advantage plans, use in-network healthcare providers.
If you would like more information, have comments, or would like a copy of the Patient Rights and Responsibilities in other formats, please Contact us or call the Member Services number on the back of your health plan member ID card.
Affirmative statement:
- Carelon Health utilization management decision-making is based only on appropriateness of care, services, and the existence of coverage.
- CareMore Health does not reward healthcare providers or other individuals for issuing denials of coverage or care.
- Financial incentives for utilization management decision makers do not encourage decisions that result in underutilization.
CONTACTING YOU
We, including our affiliates or vendors, might call or text you using an automated telephone dialing system and/or a prerecorded message. But we only do this in accordance with the Telephone Consumer Protection Act (TCPA). The calls may be to let you know about treatment options or other health-related benefits and services. If you do not want to be contacted by phone, just let the caller know and we won’t reach out this way in the future. You may also call toll-free at 1-844-203-3796 to place your phone number on our internal Do Not Call list.
We do not share mobile contact information with third parties or affiliates for marketing or promotional purposes. Information may be shared with subcontractors in support services, such as customer service. All other categories exclude text messaging originator opt-in data and consent; this information will not be shared with any third parties.
We may provide email links to further facilitate communication between you and us. Information collected through email may be shared with our member services department, other associates, or third parties that perform services on our behalf. Unless otherwise noted, email through our website is not a completely secure and confidential means of communication. Non-encrypted email may be accessed and viewed by other Internet users without your knowledge and permission while in transit to us.
WEB PRIVACY STATEMENT
Your privacy is very important to us and we will make every reasonable effort to safeguard any information we collect.
What information will we collect?
Information may be collected in the following ways on this website and Application:
- If we provide user account access, you may elect to establish an account so that you can gain additional access to online service applications, health tools, health information, subscriptions or other services where it is important for us to know who you are in order to best meet your needs. Providing personal information is always voluntary.
- We may use “cookies” to help us improve this website and Application by tracking your navigation habits and to store some of your preferences. A cookie is a small file created by a website or application to store information on your computer. Cookies do not allow websites or applications to gain access to other information on your computer. Once a cookie is saved on your computer, generally only the website or application that created the cookie can read it.
- An Internet Protocol (IP) address is a number that automatically identifies the computer or mobile device that you are using to access the Internet. The IP address enables our server to send you the site pages that you want to visit or the data you want to view. The IP address may disclose the server owned by your Internet Service Provider. We use your IP address to help diagnose problems with our server and to support our administration of this website and Application.
How will information be used?
Any personal information that you provide is used for the purpose for which you provide it. For example, if you email us for information, we may use your email address to respond to you.
We may also gather quantitative user information, such as the number of users and the pages or data accessed, in order to perform administrative, technical, hosting, or other functions that help us manage our website and Application and deliver new functionality to you. We do not sell, license, transmit, or disclose personal information that you provide to us to third parties except with the following exceptions:
- Upon your authorization;
- When such disclosure is necessary to allow us and our contractors or agents to carry out treatment, payment or health care operations; or
- When required or permitted by law.
Third parties
We may work with third-party service providers who may place third-party persistent cookies, web beacons, or similar technologies to collect anonymous information about the use of our websites and Applications. They are not permitted to collect any personal information, and this information will be solely used for web usage analysis for a better understanding of how you use our website Application, and/or to customize our content and advertising.
What if I don’t want information about me to be collected?
Providing personal information through this website or Application is optional. Personally identifiable information will not be collected from you without your knowledge and approval.
If you do not wish to have your activity on our website or Application tracked, you can opt-out at any time here to discontinue first party cookie tracking of your web activity.
You also have the choice to opt-out of third-party cookies, web beacons or similar technologies, if you do not want third-party service providers to collect your anonymous information for marketing purposes, visit the Network Advertising Initiative (NAI) website to perform the opt-out .
Additionally, you can direct your Internet browser to notify you and seek approval whenever a cookie is being sent to your hard drive. You may also delete a cookie manually from your computer, tablet or smartphone through your Internet browser settings or other programs. You can also set your browser to refuse all cookies. Please note that some parts of this website or Application may not function properly or be available to you, if you refuse to accept a cookie or choose to disable the acceptance of cookies.
“Do Not Track” Signals
We do not respond to web browser “do not track” signals. As such, your navigation of our website and Application may be tracked as part of the gathering of quantitative user information described above. If you arrive at our website or Application by way of a link from a third-party application that does respond to “do not track” requests, the recognition of any “do not track” request you have initiated will end as soon as you reach our website or Application.
Linking to Other Sites
From time to time we will provide links to websites or applications not owned or controlled by us. We do this because we think the information might be of interest or use to you. A link to a third-party website or application does not constitute or imply endorsement by us. We cannot guarantee the quality or accuracy of information presented on third-party websites or applications. While we do our best to ensure your privacy, we cannot be responsible for the privacy practices of third-party websites or applications. We encourage you to review the privacy practices of any website or application you visit.
Questions
If you have questions regarding this policy, please email us at CareMorePrivacy@CareMore.com.
This privacy statement is effective June 1, 2022. This privacy statement is subject to change. We encourage you to review it from time to time.
CONSUMER PRIVACY PROTECTION INFORMATION