Provider Choice

RIGHTS & RESPONSIBILITIES FOR MEMBERS OF PERFORMCARE

As a member of PerformCare you have rights and responsibilities, which are listed below. If you need help understanding your rights and responsibilities, or if you have questions or concerns, you can discuss these with your provider or contact PerformCare.

In the Capital Area, the contact information for PerformCare is as follows:

Member Services: 1-888-722-8646

Member Services TTY/TDD: 1-800-654-5984 or PA Relay 711

Consumer and Family Affairs: 1-717-671-6541

YOUR RIGHTS

* Receive Information. Each Member has the right to receive information about PerformCare, its policies and procedures, its services, its practitioners and Providers, and your rights and responsibilities

*Dignity and Privacy. Each Member is guaranteed the right to be treated with respect and with due consideration for his or her dignity, right to privacy, and right to confidentiality

*Receive information on available treatment options. Each Member is guaranteed the right to receive information on medically necessary available treatment options and alternatives, presented in a manner appropriate to the Member's condition and ability to understand, regardless of cost or benefit coverage

*Participate in Decisions. Each Member is guaranteed the right to participate in decisions regarding his or her health care, including the right to refuse treatment. You can be a part of your treatment team by asking questions and getting answers before and during your treatment and involving family Members and other important people in your treatment

*Refuse Treatment. Each Member, as part of making decisions regarding their care, can refuse treatment. You have the right, under these circumstances, to get an explanation of what may happen if you don't get treatment

*Voice complaints or appeals. Each Member has the right to voice complaints or appeals about PerformCare or the care provided to them. Let us know if you are unhappy about any decision made by us or one of our Providers

*Make Recommendations. Each Member has the right to make recommendations regarding PerformCare's Members rights and responsibilities policies

*Freedom from Restraint or Seclusion. Each Member is guaranteed the right to be free of any restraint or seclusion used as a means of coercion, discipline, convenience or retaliation

*Copy of medical records. Each Member is guaranteed the right to request and receive a copy of his or her medical records, and to request that they be amended or corrected.

*Free Exercise of Rights. Each Member is free to exercise his or her rights, and that the exercise of those rights does not adversely affect the way the Member is treated by PerformCare and the Provider.

You also have the right to:

*Choose your provider.

*Ask for a therapist who understands your language and culture.

*Receive needed services at convenient times and places.

*Receive emergency care within one hour.

*Received urgent care within 24 hours.

*Receive care within seven days of your request for routine care.

*To recovery oriented services

YOUR RESPONSIBILITIES

*To Supply Information. Each Member has the responsibility to supply information (to the extent possible) that PerformCare and its practitioners and Providers need in order to provide care

*To Follow Instructions. Each Member has the responsibility to follow plans and instructions for care that they have agreed on with practitioners

*To Understand. Each Member has a responsibility to understand their health problems and participate in mutually agreed-upon treatment goals to the degree possible

*To treat others with consideration and respect

*To be at appointments on time

*To call if you must cancel an appointment or reschedule an appointment

*To be part of the treatment team by telling your doctor or therapist about symptoms and to ask questions

*To tell your doctor or therapist if you do not agree with recommendations

*To tell your doctor or therapist when/if you want to end treatment

*To take medication as prescribed and to tell your doctor if there is a problem

*To carry your insurance cards with you

*To tell PerformCare if you have other insurance

SECOND OPINION

Another important right PerformCare Members need to know about is the right to request a second opinion. Members can request a second opinion from a qualified health care professional within PerformCare's network. PerformCare will provide for a second opinion from an appropriate behavioral health care professional within the network or arrange for the Member to get one outside the network at no cost to the Member.

Call PerformCare for more information about this right and benefit.

If you feel that your rights have been violated or if you want more information about these and other rights, please call PerformCare.