Rights & Responsibilities

Section Banner Image

Case Management Rights and Responsibilities

As a participant in the case management program, members have the right to: 

  • Be educated about their rights;
  • Be informed of choices regarding services;
  • Have input into the case management plan;
  • Refuse treatment or services, including case management services and the implications of such refusal relating to benefits eligibility and/or health outcomes;
  • Use end of life and advance care directives;
  • Obtain information regarding the organization’s criteria for case closure;
  • Receive notification and a rationale when case management services are changed or terminated; and
  • Obtain information on alternative approaches when the consumer, family and/or caregiver is unable to fully participate in the assessment phase.
  • File a complaint regarding the case management program by contacting Customer Service by phone at 1-800-410-7778 or by writing to MHBP, PO Box 8402, London, KY 40742.

Members have the responsibility to: 

  • Accurately and completely disclose relevant information and notify Coventry Health Care of any changes.
  • Become involved in individually specific health care decisions.
  • Work collaboratively with Coventry Health Care representatives in developing goals and implementing interventions to manage their condition.
  • Work collaboratively with health care providers in developing and carrying out agreed-upon treatment plans.
  • Make a good-faith effort to maximize healthy habits, such as exercising, not smoking and eating a healthy diet.
  • Abide by the administrative and operational procedures of our case management program.
     

Disease Management Rights and Responsibilities

As a participant in the disease management program, members have the right/responsibility to:

  • The right to know about the philosophy and characteristics of the disease management program;
  • The right to have personally identifiable health information shared by the disease management program only in accordance with state and federal law;
  • The right to identify the staff member and their job title and to speak with a supervisor of the staff member if requested;
  • The right to receive accurate information from the disease management program;
  • The right to receive administrative information regarding changes in or termination of the disease management program;
  • The right to decline participation, revoke consent or dis-enroll at any point in time;
  • The responsibility to submit any forms that are necessary to participate in the program, to the extent required by law;
  • The responsibility to give accurate clinical and contact information and to notify the disease management program of changes in this information; and;
  • The responsibility to notify their treating provider of their participation in the disease management program (if applicable).