Statement of Member’s Rights and Responsibilities

Healthcare Highways is committed to preserving and respecting members’ rights. We expect our network providers, including individual practitioners, to support and act in accordance with these rights. Members have the right to:

• Receive accurate, easy-to-understand information about Healthcare Highways, the services we provide, the providers in our networks, the rights of members treated by Healthcare Highways Network providers, and how to contact us regarding concerns about Healthcare Highways services.

• Be treated with respect and recognition of their dignity and the right to privacy, including protecting the confidentiality of medical and other personal information and members’ rights to review their medical and personal information on file at Healthcare Highways, as required by applicable state and federal law.

• Communicate with providers in making decisions about their healthcare without interference from Healthcare Highways.

  Register complaints about Healthcare Highways, our services, determinations, or the care provided by a Healthcare Highways network provider, including the right to have complaints addressed in a timely manner through formal procedures that are appropriate to the nature of the complaint.

  Choice of healthcare providers from the Healthcare Highways Network, consistent with the terms of the employees’ health benefit plans and applicable state and federal law.

• Receive healthcare services without discrimination, as Healthcare Highways network providers are precluded by contract from differentiating or discriminating against members in the provision of healthcare services because of certain member characteristics and are required to render such services to all members in the same manner, in accordance with the same standards, and with the same availability as are offered to the network provider’s other patients.

Rights and Responsibilities

• Supply information (to the extent possible) that Healthcare Highways and its providers need to provide care.

• Follow the plans and instructions for care to which they have agreed with their providers.

• Ask questions necessary to understand their health problems and participate with their providers in developing and complying with mutually agreed-upon treatment goals.

Healthcare Highways uses its best efforts to ensure that all members are afforded these rights. If you feel that your rights as a member have not been met, Healthcare Highways has a formal complaint-resolution process you can use.

To begin the complaint resolution process, please describe your complaint in writing, include your complete contact information, and mail to:

Healthcare Highways
3001 Dallas Parkway, Suite 700
Frisco, Texas 75304
Attn: Corporate Quality Management