PHC Florida

Robert Heglar
AHF Provider

Member Rights and Responsibilities

As a member of PHC Florida, you have the right to:

  • Be  provided with facts about benefits, services, and use of the managed care  plan
  • Receive kind, respectful care and be treated with human dignity
  • Know the names and titles of all doctors and other health care providers involved in your medical treatment
  • Understand your medical condition and health status, suggested course of treatment, alternatives, and risks involved
  • Actively participate in decisions regarding your medical care
  • Be informed of continuing health care requirements following discharge from the hospital or provider office
  • Refuse treatment, providing you choose to accept responsibility and the possible results of such a decision
  • Refuse to participate in any medical research projects
  • Have all complaints and grievances forwarded to the managed care plan’s Member Services Department for appropriate response
  • Access to your medical records and have the privacy and confidentiality of these records maintained
  • Complete an advance directive
  • Make suggestions for improvement to PHC Florida.
  • Appeal unfavorable medical or administrative decisions by following the established appeal procedures of PHC Florida and the State
  • Have all the above rights apply to the person having legal authority to make decisions regarding your health care
  • Have all managed care plan personnel observe your member rights
  • Exercise these rights without regard to sex, age, race, ethnic, economic, educational, or religious background

As a member of PHC Florida, you are responsible to:

  • Understand how PHC Florida works by reading the plan’s Enrollee Handbook (effective July 1, 2018)
  • Carry your PHC Florida ID card and Medicaid card with you at all times.  Present them to each provider (doctor, lab, hospital, pharmacy, etc.) at the time services are being provided.
  • Select and seek all non-emergency care by appointment through your assigned primary care provider (PCP), obtain a referral from your PCP for specialty care, and cooperate with all persons providing your care and treatment
  • Be on time for appointments
  • Notify the doctor’s office well in advance if you need to cancel or reschedule an appointment
  • Be respectful of the rights, property, and environment of all providers, employees, other patients and not be disruptive
  • Understand and follow medical advice concerning your treatment and ask questions if you do not understand or need an explanation
  • Understand the medications you take, know what they are, what they are for, and how to take them properly.
  • Provide  accurate and complete medical information to all providers as may be required in the course of your treatment
  • Make sure your current doctor has been provided with copies of all previous medical records
  • Notify PHC Florida within 48 hours or as soon as possible, if you are hospitalized or receive emergency room care

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AHCA 062614 PHC MMA Form 17.0