MercyCare offers members a three-way partnership between you, your doctors and your health plan. Our goal is to assure you receive appropriate, quality health care and develop a relationship with a Primary Care Physician (PCP) who coordinates and manages your medical care. Your rights and responsibilities as part of the MercyCare partnership are described below.
As a member, you have the right to:
- Receive information about the MercyCare organization, services, practitioners, hospitals, other providers and member rights and responsibilities
- Be treated with respect and recognition of your dignity and right to privacy
- Take part in decisions regarding your treatment
- Discuss openly and freely all planned treatments, procedures and services
- Confidentiality of your personal health information as described in your Health Insurance Portability and Accountability Act (HIPAA) notice of privacy practices
- Know how to obtain health care services
- Know what your benefits are
- Understand the purpose and probable results and risks of treatment
- Initiate a complaint about care or service you receive as a MercyCare member and receive a timely response when you call customer service at (800) 895-2421
- Make recommendations regarding the organization’s member rights and responsibilities policies by contacting customer service at (800) 895-2421
As a member, you are responsible to:
- Provide information about your past illnesses, hospitalizations, medications and other matters concerning your health that will help your practitioner understand your health care needs and provide appropriate care
- Understand any health problems you may experience and develop mutually agreed upon treatment goals and plans with your practitioner
- Cooperate as much as possible with mutually agreed upon treatment goals and advice of your health care practitioner
- Read and understand your MercyCare member handbook, certificate of coverage, schedule of benefits and provider directory
- Choose a PCP with whom you will coordinate your care
- Identify yourself as a MercyCare member by presenting your insurance card before receiving health care services
- Pay your co-payments at the time of your visit
- Keep your appointments
- Discuss any questions you have about your health with your practitioner
- Notify MercyCare of address, telephone or other status changes within 30 days of any change
For more information about your rights and responsibilities, contact MercyCare by phone at (800) 895-2421 or email mcare@mhsjvl.org.
