GVS |

PATIENT BILL OF RIGHTS

PATIENT BILL OF RIGHTS

• Patients have the right to understand and use these rights.  If for any reason patients do not understand the rights or require assistance, General Vision Services’ staff will provide assistance.
• Patients have the right to receive treatment without discrimination as to race, color, religion, sex, age, national origin, disability, sexual orientation or source of payment.
• Patients have the right to receive materials that clearly explain the scope of covered benefits, such as information regarding accessing covered benefits, including requirements for prior authorization and accessing emergency or out-of-area services; cost-sharing features under the benefit plan and coverage exclusions.  Patients have access to a directory of participating providers.
• Patients have the right to expect continuity of care and to know in advance what appointment times and services are available by locations.
• Patients have the right to avail themselves to the plan’s services and options and the provider agrees to accept the plan fees as payment in full.  Where co-payments are applicable, patients have the right to an explanation of all such charges.  Patients have the right to choose non-plan materials with the understanding that they are responsible for all applicable charges.
• Patients have the right to be shown the General Vision Services Collection and choose a frame from the GVS carousel collection (where applicable).
• Patients (and their dependents when appropriate) have the right to know all options, therapies, treatments and services available to them regardless of any restrictions imposed by the vision care plan.  Patients shall be informed of all professional fees not covered by the plan prior to the provision of such services.
• Patients have the right to receive considerate and respectful care in a clean and safe environment.
• Patients have the right to know the names, qualifications and licenses of all providers involved with their care.  If an optometrist is involved, they have the right to know whether the provider is certified to use diagnostic pharmaceutical agents and/or therapeutic pharmaceutical agents.
• Patients have the right to receive complete information about their diagnosis, treatment and prognosis.  Patients are expected to provide all necessary information to providers to facilitate effective treatment.  Patients are responsible for providing, to the best of their knowledge, accurate and complete information about their complaints, medical and family history, eye and vision history and any other pertinent information.
• Patients have the right to refuse treatment and be told what effect this may have on their health.
• Patients have the right to privacy while in the office and confidentiality of information and records regarding their care.  Patients have the right that safeguards be adopted to protect their privacy and the confidentiality of all patient data gathered by General Vision Services’ participating providers.  The release of protected information will be provided only to authorized agents and appropriate regulatory authorities.
• Patients have the right to review, comment upon and request correction of health information on their medical record and obtain a copy of the medical record, for which the office may charge a reasonable fee.  Patients cannot be denied a copy solely because they cannot afford to pay.
• Patients have the right to receive the General Vision Services Privacy Practices Notice describing how their medical information may be used and disclosed and how they may gain access to this information as dictated by the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
• Patients have the right to receive, without charge, a copy of their eyeglass prescription.  Patients wearing contact lenses may, depending on the state in which services have been provided, have a right to receive a copy of their contact lens prescription only after the lens fit has been confirmed.
• Patients have the right to be satisfied with the care and treatment provided.  Patients have the right to voice their grievances, objections and dissatisfaction regarding the care and/or the cost of treatment of care received without the fear of reprisal.  Patients have the right to appeal decisions initially unfavorable to their position.  Patients have the right to a system that provides for the receipt and resolution of complaints and grievances in a timely manner.

• Present complaints.
• Medical History and any other significant events, including surgical history.
• Eye and vision history, social and family history.
• Current medications.
• Allergies and reactions.
• Any other pertinent information.

Members are also responsible for:

• Reporting when they lack a clear understanding of a proposed course of action and what may be expected of them.
• Following treatment recommendations, including using prescribed medications or treatments and reporting any factors that may prevent them from doing so.
• Respecting the rights of others, including, but not limited to, other patients, staff and providers.
• Assuring that the financial obligations associated with their care, including co-payments and fees for non-covered services, are met in a timely manner.
• Notifying providers at the time an appointment is made that they are covered by a General Vision Services Plan.
• Notifying providers at least 24 hours in advance when canceling any appointment.
• To use the benefit in an honest manner.
• Members are permitted to question providers about all treatment options and provider’s compensation arrangement with General Vision Services.
• Ensuring that their provider has received the proper authorization for services.
• Reporting any concerns to General Vision Services at 1-800-VISION-1.