Patient Rights

  1. The right to know about the philosophy and characteristics of the patient management program.
  2. The right to have personal health information shared with the patient management program only in accordance with state and federal law.
  3. The right to identify the program’s staff members, including their job title, and to speak with a staff member’s supervisor if requested. Patients can reach the pharmacy staff from 8:30 A.M. to 5:30 P.M. Eastern Standard Time Monday through Friday at 855-553-3568.
  4. The right to speak to a health professional.
  5. The right to receive information about the patient management program.
  6. The right to receive administrative information regarding changes, in or termination of, the patient management program.
  7. The right to decline participation, revoke consent, or dis-enroll at any point in time.
  8. The right to participate in decisions about health care, give or withhold informed consent and be involved in developing a care plan.
  9. The right to refuse any or all treatment and to be informed of the possible consequences of refusing care.
  10. The right to be treated with dignity, courtesy, and respect. Patients will receive quality medications and services that meet or exceed professional and industry standards, regardless of race, sexual orientation, religion, political beliefs, sex, social or economic status, age, disease, DNR status, and treatment and service decisions.
  11. The right to receive information in a manner, format, and language most understandable to the patient. Patients also have the rights to have a family member or surrogate decision maker involved in care, treatment, and service decisions.
  12. The right to request documentation supporting evidence-based practice for clinical decisions including: manufacturer package insert, published practice guidelines, peer-reviewed journal articles, etc. The documentation should include the level of evidence or consensus when no, or conflicting, evidence-based research is available.
  13. The right to be offered assistance with internal programs designed to provide patient management services, manufacturer co-pay assistance programs, or health plan assistance programs, including tobacco cessation, disease state management, suicide prevention, and behavioral health services.
  14. The right to receive confidentiality and privacy of all protected health information (PHI) contained in medical records, except where permitted by law or third party payer contracts. Patients have the right to receive notification of disclosure of PHI, including where and to whom the information was disclosed as permitted by law and as specified in company policies and procedures.
  15. The right to receive a referral to other health providers outside of the health system including dieticians, pain management, and behavioral health services. Patients may also be referred to their current provider for follow-up.
  16. The right to be free from mistreatment, neglect, abuse of any kind (verbal, mental, sexual, or physical), injuries of unknown source of misappropriation of patient property.
  17. The right to express dissatisfaction, concerns, or complaints with regards to lack of respect, dissatisfaction of treatment, or failure to provide services in a timely manner. Patients may suggest changes in policy or procedure without fear of discrimination, restraint, reprisal, coercion, or unreasonable interruption in services.

Patient Responsibilities

  1. The responsibility to submit any forms necessary to participate in the program, to the extent required by law.
  2. The responsibility to give accurate clinical and contact information, and to notify the patient management program of changes to this information.
  3. The responsibility to notify their treating provider of their participation in the patient management program, if applicable.
  4. The responsibility to adhere to the treatment plan or service.
  5. The responsibility to participate in the development of an effective plan of care, treatment, and services.
  6. The responsibility to be honest and direct, and to ask questions concerning care, treatment, and services.
  7. The responsibility to request clarification of any instruction provided by pharmacy representatives.
  8. The responsibility to communicate information, concerns, and questions related to perceived risks in therapy or changes in condition.
  9. The responsibility to treat pharmacy personnel with respect and dignity without discrimination as to color, religion, sex, sexual orientation, or ethnic origin.
  10. The responsibility to use medications according to the provided instructions and for the purpose they were prescribed. The patient is responsible to not share medications with others.
  11. The responsibility to communicate any concerns regarding the ability to follow the provided instructions.
  12. The responsibility to notify Proprium Pharmacy of changes in insurance coverage as soon as possible.
  13. The responsibility to notify Proprium Pharmacy of changes in telephone number or address as soon as possible.