Esperanza Patient Bill of Rights and Responsibilities
These rights can be exercised on the patient’s behalf by a designated decision maker if the patient lacks decision-making capacity, is legally incompetent, or is a minor.
You Have The Right To:
- Be treated with dignity and respect at all times.
- To receive services regardless of age, sex, race, creed, color, religion, ethnic origin, ancestry, marital status, physical or mental disability, gender preference, veteran status or criminal record.
- To receive services without regard to one’s ability to pay; if you are unable to pay the full fee for services, a sliding fee scale is available to you.
- Know the names of those treating you.
- Receive quality services from qualified personnel.
- Expect reasonable continuity of care when appropriate, and to be informed of available and realistic options when your provider is not able to see you.
- Phone access to a provider via the answering service for urgent issues which occur after business hours, and cannot medically wait for the next business day.
- Obtain relevant, current and understandable information concerning your diagnosis, treatment and prognosis.
- Participate in treatment planning, including the right to refuse service or treatment.
- File a complaint if you feel your rights have been violated.
- Request that a staff person pray with you, or refuse prayer if you do not want it.
- EHC will keep your personal health information confidential. Medical staff responsible for treatment, payment or operations will have access to these records. Personal health information requested for other purposes will require your written consent, except as required by law.
Your Responsibilities as an Esperanza Patient:
- Arrive on time for appointments, and call in advance to cancel if you cannot come.
- Provide all information about your past care, illnesses and medications to your health care provider when he/she is trying to find out the best possible treatment for you.
- Inform your provider of anticipated problems in following any prescribed treatment plan.
- Request additional information or clarification about your health or treatment when you do not fully understand the information or instructions.
- Provide accurate health insurance information at the time of each visit, and pay at the time services are received.
- Provide supporting financial documentation if you have no insurance; notify us when your financial situation changes; and pay at the time services are received.
- Receive an explanation of your bill, and to meet with billing staff to discuss payments.
- Supervise your children in the center.
- Request referrals at least 2 full business days prior to the time it is needed.
- Not bring drugs, alcohol or weapons of any kind to Esperanza Health Center.
- Be respectful and honest in dealing with staff; be considerate of other patients.