• 1933 Washington Blvd Belpre, OH 45714
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Patient Rights & Responsibilities

Patient Rights & Responsibilities

Patient Rights and Responsibilities

Care Without Discrimination.

The patient always has the right to considerate, competent, professional and respectful care from all members of our clinic and surgery center staff at all times and under all circumstances. Patients will never be discriminated against in the provision of health care benefits covered in their policy and/or as required by Law, based on race, ethnicity, national origin, religion, sex, age, current or anticipated mental or physical disability, sexual orientation, genetic information, or source of payment.

ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call 1-877-746-4674

SPANISH
ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-877-746-4674
GERMAN
ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer 1-877-746-4674.
FRENCH
ATTENTION : Si vous parlez français, des services d’aide linguistique vous sont proposés gratuitement. Appelez le 1-877-746-4674
ITALIAN
ATTENZIONE: In caso la lingua parlata sia l’italiano, sono disponibili servizi di assistenza linguistica gratuiti. Chiamare il numero 1-877-746-4674.
ARABIC
مقر) 1-877-746-4674 مقرب لصتا .ناجملاب كل رفاوتت ةیوغللا ةدعاسملا تامدخ نإف ،ةغللا ركذا ثدحتت تنك اذإ :ةظوحلم :مكبلاو مصلا فتاھ

CHINESE
注意:如果您使用繁體中文,您可以免費獲得語言援助服務。請致電)。1-877-746-4674
POLISH
UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej. Zadzwoń pod numer 1-877-746-4674.
PENNSYLVANIA DUTCH
Wann du [Deitsch (Pennsylvania German / Dutch)] schwetzscht, kannscht du mitaus Koschte ebber gricke, ass dihr helft mit die englisch Schprooch. Ruf selli Nummer uff: Call 1-877-746-4674.
RUSSIAN
ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 1-877-746-4674.
GREEK
ΠΡΟΣΟΧΗ: Αν μιλάτε ελληνικά, στη διάθεσή σας βρίσκονται υπηρεσίες γλωσσικής υποστήριξης, οι οποίες παρέχονται δωρεάν. Καλέστε 1-877-746-4674
KOREAN
주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 1-877-746-4674 번으로 전화해 주십시오.
JAPANESE
注意事項:日本語を話される場合、無料の言語支援をご利用いただけます。1-877-746-4674 まで、お電話にてご連絡ください。
DUTCH
AANDACHT: Als u nederlands spreekt, kunt u gratis gebruikmaken van de taalkundige diensten. Bel 1-877-746-4674.
VIETNAMESE
CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn
Gọi số 1-877-746-4674
HINDI
ध्यान द􁱶: य􁳰द आप 􁳲हदी बोलते ह 􁱹तो आपके िलए मुफ्त म􁱶 भाषा सहायता सेवाएं उपलब्ध ह।􁱹 1-877-746-4674 पर कॉल कर􁱶।

The Right to Information.

The patient has the right to receive accurate, easily understood information to assist him/her in making informed decisions about health plans, facilities and professionals. The patient also has the right to obtain complete current information from the physician regarding his/her diagnosis and prognosis in terms the patient can be reasonably expected to understand. When it is not medically advisable to give such information to the patient, the information will be made available to an appropriate person on his/her behalf. He/she has the right to know, by name, the physician responsible for the patient’s care.

The Right to Choose.

The patient has the right to receive from his/her physician and/or physician’s staff member information necessary to give informed consent prior to the start of any examination, test, procedure and/or treatment. Except in emergencies, such information for informed consent will include, but not necessarily be limited to, the specific test, procedure and/or treatment, the medically significant risk(s) involved and the probable duration of incapacitation. Where medically significant alternatives for care or treatment exist or when the patient requests information for medical alternatives, the patient has the right to know the alternatives. The patient has the right to refuse treatment and/or change physicians and be informed of the medical consequences of his/her actions. In all situations or cases the patient has the right to be free from abuse or harassment.

The Right to Privacy.

The patient has the right to every consideration of his/her privacy concerning his/her own medical care program. Case discussion, consultation, examination and treatment are confidential. and will be conducted discreetly. Those not directly involved in the patient’s care must have the patient’s permission to be present. The patient has the right to expect all communications and records pertaining to his/her care be treated as confidential.

Access to Emergency Services.

Patients have the right to access emergency health services when and where the need arises. The patient has the right to expect that within its capacity, the clinics and the surgery center will provide evaluation, service and/or referral as indicated by the urgency of the case. When medically permissible, the patient may be transferred to an alternate facility only after he/she has received complete information and explanation concerning the needs for and the alternatives of such a transfer. The institution to which the patient is to be transferred must first have accepted the patient for transfer.

Right to Facility Information / Physician Ownership.

The patient has the right to obtain information as to any relationship of our clinics and surgery center to other health care and educational institutions as far as his/her care is concerned. The patient has the right to obtain information as to the existence of any professional relationships among individuals, by name, who are treating him/her. The patient has a right to know our clinic and surgery center rules and regulations and how they apply to his/her conduct as a patient. Dr. David George, Dr. Scott Strickler and Dr. Zane Lazer established Physicians Outpatient Surgery Center, Ltd. for the convenience of their patients who require surgery, and thus they have a financial interest in this surgery center.

Research.

The patient has the right to be advised if the clinic(s) or surgery center propose to engage in or perform human experimentation affecting his/her care or treatment. The patient has the right to refuse such research projects.

Billing for Services.

The patient has the right to examine and receive an explanation of his/her clinic and surgery bills, regardless of the source of payment.

Right to Time Management.

The patient has the right to expect good time management techniques to be implemented within the clinics and surgery center. Those techniques will make effective use of the time of the patient and avoid personal discomfort of the patient.

The Right to Speedy Complaint Resolution.

Patients have the right to a fair and efficient process for resolving differences with their health plans, health care providers, and the institutions that serve them, including a rigorous system of internal review and an independent system of external review. We honor the patient’s right to voice concern(s) regarding his/her care. The patient is welcome to discuss the concern(s) with his/her caregiver. The physicians, nurses, and entire staff at The Eye MDs: George, Strickler and Lazer, PLLC and Physicians Outpatient Surgery Center, Ltd. are committed to assure your reasonable care. Should you have a complaint or grievance related to either entity, please feel free to contact:

The Eye MDs Administrator: 1-800-758-3937

Physicians Outpatient Surgery Center Clinical Director: 1-888-547-1222

If your complaint or grievance is not resolved to your satisfaction, your concerns may be reported to the following agencies:

Services Received in West Virginia:
WV Bureau for Public Health Phone: 1-304-558-2971

Services Received in Ohio:
Ohio Department of Health Phone: 1-800-669-3534

Medicare Services:

Medicare Beneficiary Ombudsman: http://www.medicare.gov/claims-and-appeals/medicare-rights/get-help/ombudsman.html

Presentation of a complaint or grievance will never compromise your care under any circumstances.

Taking on New Responsibilities.

In a health care system that affords patient rights and protections, patients must also take greater responsibility for maintaining good health. The patient should provide a responsible adult to transport him/her home from the office if eyes are dilated and from the surgical facility for ALL surgeries. The patient should be respectful of all the health providers and staff, as well as other patients. The patient should report unexpected changes in his or her condition to the health care provider.

Patient Participation.

It is the patient’s responsibility to fully participate in decisions involving his/her own health care and to accept the consequences of these decisions if complications occur. The patient is expected to follow up onhis/her doctor’s instructions, take medications as prescribed, and ask questions concerning his/her own health care as he/she feels necessary. If the patient fails to follow their healthcare provider’s instructions, or if the patient refuses care, the patient is responsible for his/her own actions. The patient should provide to the best of his or her knowledge, accurate and complete information about his/her health, present complaints, past illnesses, hospitalizations, any medications, including over-the-counter products and dietary supplements, any allergies or sensitivities, and other matters relating to his or her health.

Financial Obligations.

Accept personal financial responsibility for any charges not covered by his/her insurance.

Advance Directives Policy.

It is the policy of The Eye MDs Ohio Valley Eye Physicians & Surgeons, PLLC and Physicians
OutpatientSurgery Center, Ltd. to assess for Advance Directives upon patient arrival at our facilities. Due to the
elective nature of services and procedures performed by our physicians and staff, it is our policy to initiate any and all
lifesaving measures and arrange emergency transportation to the hospital for any patient requiring acute emergency
resuscitative interventions.

For more information regarding Advance Directives, visit the American Bar Association’s Website at: http://www.abanet.org/aging/toolkit/home.

The patient should provide a copy of information that you desire us to know about durable power of attorney, health care surrogate, or other advance directive.

Updated 7/15/2015

Nondiscrimination language tag lines added 10/11/116