Rights & Responsibilities
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).