Your work related injury is being case managed by Health Management Solutions. In addition to the information contained in the introduction letter, you have certain rights as a consumer of health care. They are as follows:
You have the right to:
- Have input into the case management of your plan
- Refuse treatment or services, including case management services and the implications of such refusal relating to benefits eligibility and/or health outcomes
- The use end of life and advance care directives, as applicable
- Obtain information regarding Health Management Solutions’ criteria for case closure
- Receive notification and a rationale when case management services are changed or terminated
- Utilize alternative approaches when you and/or your family are unable to fully participate in the assessment phase
Health Management Solutions, Inc. recognizes the primary role injured workers play with regard to their care and safety. Successful medical care and return to work strategies require ongoing collaboration between the worker, employer, provider(s) and managed care organization.
Injured Worker’s Responsibilities:
- To provide, to the best of your knowledge, accurate and complete information about present conditions, past illnesses, hospitalizations, medication and other matters related to your health.
- To report unexpected changes in your condition to the responsible practitioner, as soon as possible.
- To be involved in individually specific health care decisions related to your care.
- To ask questions when you do not understand information or instructions.
- To work collaboratively with Health Management Solutions, Inc. representatives in developing goals and implementing interventions to manage your condition.
- To work collaboratively with health care providers and in developing and carrying out agreed-upon treatment plans.
- To take responsibility for your actions if you refuse treatment or do not follow the practitioner’s instructions.
- To keep appointments and when unable to do so, to notify the provider with sufficient time to reschedule.
- To not knowingly initiate or participate in fraud or abuse.
- To Report illegal or unethical behavior by physicians or other health care professionals to the appropriate societies, licensing boards, or law enforcement authorities.
If you have any questions regarding these rights, please do not hesitate to call you Nurse Case Manager or any other Nurse Case Manager at Health Management Solutions, toll free at 888-202-3515.