Painted Hills 3

 

Rights and Responsibilities Statement

GOBHI is committed to treating its Members in a manner that recognizes and respects their rights. GOBHI has a Members’ Rights and Responsibilities Statement that tells you about our commitment to you. It tells you about your rights and responsibilities. It helps you to know what to expect from your health care services and how you can participate in your care. Working with your health care provider as a partner will help you to receive the most benefits from the experience. Following is a summary of your rights and responsibilities.

Your rights:

  • To be treated with dignity, respect and recognition;  
  • To have your right to privacy respected;
  • To get our services without a referral from your doctor;
  • To get help with addiction to cigarettes, alcohol and drugs without a referral;
  • To get a referral from us to see a specialist when needed;
  • To request a second opinion from a health care professional;
  • To get preventative services;
  • To have equal access to mental health services in a timely manner;
  • To receive culturally and linguistically appropriate services and supports;
  • To help us assign you to a mental health provider;
  • To change your mental health provider for a good reason;
  • To get information about all behavioral health services covered and not covered by GOBHI;
  • To get information about GOBHI, its services, its practitioners and providers, and your rights and responsibilities;
  • To be given information about your illness;
  • To participate with your provider in making decisions about your health care;
  • To open discussion of treatment options and alternatives regardless of cost or coverage;
  • To work together with your provider in pursuing your goals for recovery;
  • To be told about your options for care and to make a decision;
  • To be free from any form of restraint or seclusion used as means of coercion, discipline, convenience, or retaliation, CFR 438.100;
  • To be given the right to file a complaint about discrimination except for court-ordered services;
  • To refuse care and to be told what that means for your health;
  • To make a written statement of your treatment wishes;
  • To talk to your provider and expect that what you say will be kept private;
  • To have a clinical record kept about your condition, services received, and referrals made;
  • To review and request copies of your clinical records;
  • To have your records given to another provider with your approval;
  • To make a complaint or appeal about GOBHI or one of our providers and receive a timely answer;
  • To receive  a Notice of Action letter if you are denied a service or there is a change in service level
  • To be given information and helped to appeal denials and ask for a DHS hearing;
  • To be given handbooks, letters and notices that you can understand and have explained if needed;
  • To get interpreter and translation services at no cost to you, if needed;
  • To have a friend, family member or advocate present during appointments; 
  • To get urgent care 24 hours a day, 7 days a week; and
  • To make recommendations about GOBHI’s rights and responsibilities policy.

Your Responsibilities:

  • To keep appointments and be on time;
  • To call your provider when you are going to be late or can’t keep an appointment;
  • To get mental health services from us or your assigned provider except in an emergency;
  • To help us assign you to a mental health provider;
  • To tell us of any mental health emergency within 3 days;
  • To treat your provider and our staff with respect;
  • To tell GOBHI and your providers about your mental health problems;
  • To understand your health problems;
  • To ask questions about things you don’t understand;
  • To decide about care before it is given;
  • To tell your DHS worker of a change of address and phone number and changes to your household;
  • To take your Oregon Health ID card with you whenever you need care;
  • Your Responsibilities (continued)
  • To show your Oregon Health ID to your GOBHI provider before you receive services;
  • To tell us or your DHS worker of any other insurance you have;
  • To participate in developing mutually agreed- upon treatment goals;
  • To assist us in getting payment from other insurance;
  • To help your provider come up with a treatment plan you will follow;
  • To follow plans and instructions for care that you agree to with your provider;
  • To pay for services not covered under your OHP benefit package if you sign an Agreement to Pay form before you get the service;
  • To work together with your provider on your goals for recovery.
  • To help your provider get your previous mental health records or fill out new ones;
  • To be sure you have approval from us before going to a specialist;
  • To bring an issue, complaint, or grievance to the attention of the community mental health plan or GOBHI.

If you would like paper copies of our Members’ Rights and Responsibilities Statement, please contact Member Services at 1-800-493-0040.