Patient Rights and Responsibilities

You have the right to:

• Considerate and respectful service.
• Service without regard to race, creed, national origin, gender, sexual preference, age, disability or illness, or religious affiliation.
• Speak with a health care professional.
• Confidentiality of all information pertaining to you, your medical care and service, and to have personal health information shared in accordance with state and federal law.
• A timely response to your request for service and to expect continuity of services.
• Select the home medical equipment supplier of your choice.
• To information on your treatment outcomes.
• Make informed decisions regarding your care planning.
• Agree to or refuse any part of the plan of service or plan of care.
• An explanation of charges including policy for payment.
• Voice grievances or complaints regarding treatment of care without fear of termination of service or other reprisals.
• Be treated with respect, consideration, and recognition of client/patient dignity and individuality.
• Be free from mistreatment, neglect, or verbal, mental, sexual, and physical abuse, including injuries of unknown sources, and misappropriation of client/patient property.
• Have your communication needs met.

You have the responsibility to:

• Provide accurate and complete information to Lingraphica regarding your medical history and current condition, any payers which may cover your care, financial information, and to promptly inform Lingraphica of changes in this information.
• Provide Lingraphica with a guardian decision-maker if you are unable to make decisions regarding care, treatment, or services, in accordance with state and federal law, if you desire.
• Participate in planning, evaluation, and revising your care plan to the degree that you are able to do so.
• Adhere to the plan of care, which you participated in developing.
• Ask questions about any part of the plan of care that you do not understand.
• Protect the equipment from fire, water, theft, or other damage while it is in your possession.
• Use the equipment for the purpose for which it was prescribed, following instructions provided for use, handling care, safety, and cleaning.
• Supply us with needed insurance information necessary to obtain payment for services and assume responsibility for charges not covered. You are responsible for settlement in full of your account.
• Notify us immediately of equipment failure, damage, or need of supplies.
• Accept the consequences for any refusal of treatment or choice of noncompliance, including changes in reimbursement eligibility.
• Submit any forms that are necessary to participate in the clinical program, to the extent required by law.
• Give accurate clinical and contact information and to notify Lingraphica of any changes in this information.

For questions or more information about your right to a Good Faith Estimate, visit  www.cms.gov/nosurprises or call Lingraphica at (888) 965-6005.