Rights and Responsibilities

Member Rights

As a Neighborhood member, you have the following rights:

To receive information about Neighborhood, its services, practitioners, and providers, and members’ rights and responsibilities.
To be treated with respect and recognition of your dignity and right to privacy.
To participate with your practitioners in decision-making about your health care.
To privacy of all records and communications as required by law. (Neighborhood employees follow a strict confidentiality policy regarding all member information.)
To be treated respectfully and receive personal attention without regard to your race, national origin, gender, gender identity, age, sexual orientation, or religious affiliation.
To not be discriminated against due to preexisting conditions, medical condition, claims experience, receipt of health care, medical history, genetic information, evidence of insurability, or disability.
To an open discussion of appropriate home and community services or medically necessary treatment options for your conditions, regardless of cost or benefit coverage.
To get a second medical opinion for medical and surgical concerns.
To voice grievances or appeals about Neighborhood or the care provided by its practitioners and/or agencies.
To contact the State’s Enrollee Ombudsman for assistance with any matter related to the care or service provided by Neighborhood or its practitioners and/or agencies
To make recommendations about Neighborhood’s Member Rights and Responsibilities policies.
To refuse treatment, and if you do, it will not affect your future treatment.
To receive information on available treatment options and alternatives.
To be free from any form of restraint or seclusion used as a means of coercion, discipline, convenience or retaliation.
To request and receive a copy of your medical records, and request that they be amended or corrected.
To be given health care services and reasonable accommodations.
To receive health care services covered by Neighborhood without getting a bill after Neighborhood pays, by one of our providers or practitioners.
To exercise your rights, and that the exercise of those rights does not negatively affect the way Neighborhood and its providers treat you. (Violation of this policy by Neighborhood staff will result in disciplinary actions.)
To understand the requirements and benefits of the plan.
To receive member materials in a manner that can easily be understood, including formats that take into consideration members with special needs.
To include an inpatient hospital stay following childbirth for mothers and newborns.

Member Responsibilities

As a Neighborhood member, you have the following responsibilities:

To choose a PCP and primary care site. Your PCP will coordinate all of your medical care. You may change your PCP at any time by calling Neighborhood Member Services.
To have all of your medical care provided by, or arranged by, a provider in the Neighborhood network. This rule does not apply to emergency or urgently needed care, kidney dialysis services at a Medicare-certified dialysis facility and family planning services.
To carry your Neighborhood member ID and your Rhode Island Medical Assistance card with you.
To provide, to the extent possible, information that Neighborhood and its practitioners and providers need to care for you.
To learn about your health problems and help plan treatment you and your provider agree on.
To follow the plans and instructions for care that you have agreed on with your providers.
To talk with your PCP about all specialty care. If you need a specialist, your PCP will work with you to make sure you get quality care.
To let Neighborhood know about any changes to your name, home address, telephone number, or if you have other insurance coverage.

Call Neighborhood Member Services if you have any questions about your rights and responsibilities. Member Services can be reached at 1-844-812-6896 (TTY 711), 8 am to 8 pm, Monday – Friday; 8 am to 12 pm on Saturday. On Saturday afternoons, Sundays and holidays, you may be asked to leave a message. Your call will be returned within the next business day. The call is free.

Llame a Servicios a los miembros de Neighborhood si usted tiene alguna pregunta acerca de sus derechos y responsabilidades. Los servicios de miembro puede llegarse al 1-844-812-6896 (TTY 711), de 8 am a 8 pm, de lunes a viernes, de 8 am a 12 pm los Sábados. En las tardes de los Sábados, domingos y feriados, se le pedirá que deje un mensaje. Su llamada será devuelta dentro del siguiente día hábil. La llamada es gratuita.

Neighborhood chamada os serviços se você tem quaisquer perguntas sobre os seus direitos e responsabilidades. Os Serviços podem ser alcançados em 711 1-844-812-6896 (TTY), 8 am a 8 pm, de segunda a sexta-feira; 8 am a 12 pm no sábado. Nas tardes de sábado, domingos e feriados, você pode ser convidado a deixar uma mensagem. A sua chamada será devolvido no próximo dia útil. A ligação é gratuita.

Our plan can also give you materials in Spanish and Portuguese and in formats such as large print, braille, or audio. Call Neighborhood INTEGRITY Member Services to make a standing request to receive your materials now and in the future, in your requested language or alternate format.

Questions?

Please call us at 1-844-812-6896 (TTY 711), 8 am to 8 pm, Monday – Friday; 8 am to 12 pm on Saturday. On Saturday afternoons, Sundays and holidays, you may be asked to leave a message. Your call will be returned within the next business day. The call is free.

Neighborhood Health Plan of Rhode Island is a health plan that contracts with both Medicare and Rhode Island Medicaid to provide the benefits of both programs to enrollees.

ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call Member Services at 1-844-812-6896 (TTY 711), 8 am to 8 pm, Monday – Friday; 8 am to 12 pm on Saturday. On Saturday afternoons, Sundays and holidays, you may be asked to leave a message. Your call will be returned within the next business day. The call is free.

ATENCIÓN: Si usted habla Español, servicios de asistencia con el idioma, de forma gratuita, están disponibles para usted. Llame a Servicios a los Miembros al 1-844-812-6896 (TTY 711), de 8 am a 8 pm, de lunes a viernes, de 8 am a 12 pm los Sábados. En las tardes de los Sábados, domingos y feriados, se le pedirá que deje un mensaje. Su llamada será devuelta dentro del siguiente día hábil. La llamada es gratuita.

ATENÇÃO: Se você fala Português, o idioma, os serviços de assistência gratuita, estão disponíveis para você. Os serviços de chamada em 1-844-812-6896 TTY (711), 8 am a 8 pm, de segunda a sexta-feira; 8 am a 12 pm no sábado. Nas tardes de sábado, domingos e feriados, você pode ser convidado a deixar uma mensagem. A sua chamada será devolvido no próximo dia útil. A ligação é gratuita.

Last Updated December 7, 2018

H9576_ WebRandR19 Approved 12/6/18