Patient Information

As a patient you have the right to:

• Understand and exercise these rights. As a patient you have a right to receive information in a manner that you understand. If for any reason you do not understand or need help, assistance will be provided including an interpreter.
• Become informed of these rights as a patient in advance of, or when discontinuing, the provision of care.
• Treated respectfully and receive services without regard to age, race, color, religion, sex, national origin, disability, sexual orientation or source of payment
• Have your cultural, psychosocial, spiritual and personal values, beliefs and preferences respected. Receive considerate, respectful and compassionate care, provided in a clean, safe, and smoke free environment, free from all forms of abuse, neglect, harassment and/or exploitation. Have access to protective and advocacy services in cases of neglect or abuse.
• To be called by your proper name and be told the name of the healthcare provider who has primary responsibility for your care and the names and roles of other physicians and healthcare providers involved in your care.
• Receive complete information from your healthcare provider about your diagnosis, and course of treatment. This information should also include outcomes of care (including unanticipated outcomes), and your prospects for recovery in terms that you or your representative can understand. All patients will be informed about unanticipated outcomes of care, treatment, and services that relate to sentinel events as defined by the Joint Commission. Have your pain assessed and to be involved in decisions about managing your pain.
• You need to give informed consent for any proposed treatment or procedure. This shall include the possible risks and benefits of the procedure or treatment.
• Participate in planning for care after discharge. This information shall include a description of the procedure or treatment, the medically significant risks involved in the treatment, alternate courses of treatment or non-treatment and the risks involved in each and the name of the person who will carry out the procedure or treatment.
• Participate in all decisions about your healthcare.
• Reasonable continuity of care, including referral and access to needed specialty care and other services.
• Refuse treatment in accordance with federal and state laws, and be told the impact this would have on your health.
• Refuse to take part in any clinical research trials. Refusal to participate or discontinuation of participation will not compromise the patient’s right to access care, treatment, or services.
• If you decide to participate in clinical research trials, you do not forfeit any of your patient rights. This includes the patient’s right to a full informed consent process as it relates to the research, investigation and/or clinical trial. All information provided to subjects will be contained in the medical record or research file, along with the consent form(s).
• Full consideration of privacy and confidentiality concerning your medical care and records.
• Your written permission will be obtained before your medical records can be made available to anyone not directly concerned with your care.
• Access information contained in your medical record and obtain a copy of your medical records through written request.
• Have your primary care physician or referring healthcare provider notified of your medical visit.
• Receive an itemized bill and explanation of charges regardless of the source of payment.
• Be informed of the services available.
• Know the provision for after-hours care.
• Formulate advance directives regarding your healthcare, and to have facility staff and practitioners who provide care in the facility comply with these directives (to the extent provided by state laws and regulations).
• Be advised of the grievance process, should you wish to communicate a concern regarding the quality of the care you receive. Notification of the grievance process includes: whom to contact to file a grievance, and that you will be provided with a written notice of the grievance determination that contains the name of the facility contact person, the steps taken on his or her behalf to investigate the grievance, the results of the grievance and the grievance completion date
• If the Leadership of the practice does not answer your questions to your satisfaction you may contact: Joint Commission (www.jointcommission.org or 800-994-6610), New York State Department of Health (800-804-5447) or Centers for Medicare & Medicaid Services (800-633-4227).
• Have all patient’s rights apply to the person who may have legal responsibility to make decisions regarding medical care on behalf of the patient, including involving additional family members or a surrogate as requested or necessary.

Your responsibilities as a patient:

• To take an active role in improving your health by becoming an involved member of the health care team, including sharing your expectations of the organization and your satisfaction with the organization.
• To provide accurate and complete information regarding your identity, medical history, hospitalizations, medications, dietary supplements (herbal and other nutritional supplements), and current health concerns to the best of your ability.
• Ask questions about your condition, treatments, procedures, clinical laboratory and other diagnostic test results. You should also ask a question when you do not understand the contemplated course of care or what is expected of you.
• Immediately reporting any concerns or errors they may observe, including serious side effects, complications, and unexpected changes or worsening of your condition to the responsible practitioner.
• Follow the treatment plan recommended by your healthcare provider, including the instructions of nurses and other health professionals as they carry out the provider’s orders. You are also responsible for the medical consequences that are a result of denying treatment or failing to follow the treatment plan.
• Keeping appointments and notifying the facility or the responsible healthcare provider when you are unable to do so.
• Assuring that the financial obligations of your care are fulfilled as promptly as possible, including providing information necessary for insurance processing.
• Following the facility’s rules and regulations, including those that prohibit offensive, threatening, and/or abusive language or behavior, and the use of tobacco, alcohol, or illicit drugs or substances.
• Being considerate of the rights of other patients and facility personnel and being respectful of your personal property and that of other persons in the facility.
• Providing Bridgeview Endoscopy with a copy of any advance directive or health care proxy designation that has been prepared.
• Reporting perceived risks in your care and unexpected changes in your condition to the responsible healthcare provider.
• If the Leadership of the practice does not answer your questions to your satisfaction you may contact: Joint Commission (www.jointcommission.org or 800-994-6610), New York State Department of Health (800-804-5447) or Centers for Medicare & Medicaid Services (800-633-4227).

Please be advised that if you do not give at least 24 hours’ notice of cancellation of your scheduled appointment,

a no-show fee of $150 will be billed to your account.