PA Resources Portlet
CODING & DOCUMENTATION
EDUCATION & EVENTS
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PA Dynamic Rendering
Member Rights and Responsibilities Statement
Members of Blue Cross and Blue Shield Plans have both rights and responsibilities in the management of their healthcare. Management of their healthcare includes encounters with Blue Cross and Blue Shield associates, the provider community, and their employers.
The organization's member rights and responsibilities statement specifies that members have:
- A right to receive information about the organization, its services, its practitioners and providers and member rights and responsibilities.
- A right to be treated with respect and recognition of their dignity and their right to privacy.
- A right to participate with practitioners in making decisions about their healthcare.
- A right to a candid discussion of appropriate or medically necessary treatment options for their conditions, regardless of cost or benefit coverage.
- A right to voice complaints or appeals about the organization or the care it provides.
- A right to make recommendations regarding the organization's member rights and responsibilities policy.
- A responsibility to supply information (to the extent possible) that the organization and its practitioners and providers need in order to provide care.
- A responsibility to follow plans and instructions for care that they have agreed to with their practitioners.
- A responsibility to understand their health problems and participate in developing mutually agreed-upon treatment goals, to the degree possible.