Do You Know Your Rights?
Few relationships are held more sacred than the one between patient and doctor. Most Americans are generally aware that patients have the right to choose their healthcare provider. It’s not always clear to them, however, that patient rights also cover the right to choose when it comes to physician referrals.
Given the complexity of our healthcare system, patient rights can get lost in the shuffle. Between scheduling appointments, taking medications, filing insurance claims, and coping with the stress of a medical crisis, patients often feel pressured to make quick decisions. They are often vulnerable to their physician’s authority and the dictate that patients need to “follow the doctor’s orders.”
Although patients should trust their primary healthcare provider, and it’s generally good to follow a doctor’s advice, it remains a patient’s right to choose. After all, it’s your body and your health. Ultimately, your health is your responsibility.
What Does the Law Say?
Back in 1998, the US Advisory Commission on Consumer Protection and Quality in the Health Care Industry adopted what is familiarly known as “The Patient’s Bill of Rights.” This bill was updated in 2010 along side the Affordable Care Act (ACA), but the original basic tenets have remained the same.
Your basic patient rights include:
- The right to information about quality: You can look up information about doctors’ credentials, statistics regarding hospitals and clinics, and what your health plan covers in easy-to-understand language.
- The right to choose a healthcare provider: In addition to your primary healthcare provider, this also covers specialists, who are generally physician-referred.
- The right to emergency services: You can’t be denied treatment in an emergency.
- The right to make decisions: It’s up to you to decide which course of treatment you want to follow, if at all.
- The right to respect: You must be treated with respect regardless of your sex, age, race, national origin, sexual orientation, or disability.
- The right to confidentiality: Your health information is private and cannot be released without your consent.
- The right to complain: All providers (insurance, physicians, clinics and hospitals, etc.) must have a grievance procedure.
For a fuller discussion of these patient rights, visit here.
[link the following] http://www.healthsourceglobal.com/docs/Patient%20Bill%20of%20Rights_merged.pdf.
Three Rs: Patient Rights, Responsibilities, and Referrals
As much as the Patient’s Bill of Rights protects patient rights in regard to health care, it was partly put into place as a consumer protection. For example, it is illegal for a physician to receive compensation for a referral, whether the referral is to a clinic or another individual physician. Anti-kickback laws help to assure you that your physician referral is for health-related reasons, not a doctor’s financial bottom line.
When your physician refers you to a specialist or a clinic, you should ideally receive a list of options. If the physician has any tie to a clinic or other medical provider on the list, that information must be disclosed. Because you have the right to choose a healthcare provider and the right to make decisions, it is up to you to decide which referral you will follow up with or whether you will follow-up at all.
A patient’s right to choose comes with responsibilities. It’s your responsibility to do your homework. It’s up to you to research the care providers you’ve been referred to. It’s up to you to seek a second opinion if you feel you need one. Remember, patient rights include the right to information, but it’s your responsibility to read it and base your health decisions on the information that you receive.
Most of the time, your primary healthcare provider gives you a referral when he or she determines that you need specialized care. Other times, referrals come at the request of the patient. If you have a specific health concern and want to consult a specialist or schedule an appointment at a particular clinic for which you need a referral, you do have the right to ask your healthcare provider for a referral.
Asking For a Referral
One of the goals of the US Advisory Committee when it drafted the Patient’s Bill of Rights was to encourage patients to take a more active role in their health care. Eating healthy food and exercising are certainly part of what the Advisory Committee had in mind, but taking a more active role also means taking the initiative in seeking the care you need.
Patient rights are only good if you exercise them. So how do you go about asking a physician to refer you to a specific clinic or specialist? These are the steps to follow:
1. Visit Your Primary Care Physician
Talk to your primary care physician about your concern. In most cases, health plans only cover referrals made by a physician, so your care provider will need to verify your health issue.
2. Verify Your Insurance and Referral Information
Before you proceed, check with your insurance company for your plan’s referral requirements. Not all plans are the same. Make sure that your referral is to a preferred provider so your visit will be covered.
3. Make an Appointment with the Specialist
Getting pre-approval can save you in the long run. You don’t want to get stuck with a medical bill your insurance won’t cover. Once you’re approved, make your appointment with the specialist.
Make MMRA Your Preferred Referral
Mid-Michigan Radiology Associates (MMRA) offers a number of services—from MRI and X-ray to ultrasound, dialysis, and angioplasty. Chances are good that your primary healthcare provider might recommend that you have one of these procedures. Do yourself a favor and do your homework now before you need a referral.
Cramming for an exam the night before might have worked for you in high school and maybe even college, but gathering information about specialists and clinics when you’re anxious to schedule an appointment can lead to a poor decision. Take the time now to learn about your options.
Here are a few benefits you’ll discover about the services offered at MMRA:
- Our cost for procedures is often less than other labs or clinics. You’ll receive the same high quality of health care, but your medical bill will be lower.
- Exercise your patient right to information, and you’ll discover that our staff has the knowledge and expertise you need.
- MMRA is conveniently located to serve all of mid-Michigan. You don’t have to travel downstate or out-of-state to find qualified specialists. In fact, some of our patients have come from as far as Detroit because it was worth the trip for them.
Exercising Patient Rights
At MMRA, we applaud a patient’s right to choose a health care provider. We know that you have options, so we need to earn your trust. We have been leaders in using innovative diagnostic technology for over 40 years. We have a record that will put your mind at ease.
Starting today, exercise your right to information by checking us out. Then exercise your right to choose a healthcare provider and request your physician to refer you to us. Finally, contact us to schedule an appointment.
You’ll be in our capable and caring hands. Your right to be treated with respect will be honored, and of course, we’ll protect your right to confidentiality. Isn’t it time you used your patient’s right to choose?