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1. Welcome and orient individuals to Metro East services and benefits.
2. Provide information about how to access behavioral health, primary health, and other documented service needs.
3. Provide information about how to access consumer rights processes.
4. Help with consumer inquiries regarding insurance and payor benefits.
5. Assist with facilitating the communication, resolution, and archiving of complaints and grievances.”


Patients' Rights and Responsibilities are for making informed healthcare decisions.
These include but are not limited to:
Providing information about rights, responsibilities, and protections;

1. Treating each patient with respect and recognition of their dignity and right to privacy;
2. Providing each patient with information on the structure and operation of the METRO EAST;
3. Provide information about METRO EAST, its services, its practitioners and providers, and rights and responsibilities;
4. Reiterate the Patients' freedom of choice among network providers;
5. Conduct a candid discussion of appropriate or medically necessary treatment options for the assessed conditions, regardless of cost or benefit coverage, and freely communicate without restriction on any information regarding care;
6. Inform each patient of the availability of an independent, external review of final determinations;
7. Provide information on available treatment options;
8. Participate in decisions regarding health care, the refusal of treatment, and preferences for future treatment decisions;
9. Inform the patient of those services that are not covered and may involve cost-sharing, if any;
10. Provide upon request an itemized statement for each covered service and support you provided;
11. Track the status of a claim in the claims process and obtain information over the telephone in one attempt or contact;
12. Provide information on how to receive benefits from out-of-network providers;
13. Provide information on advance directives;
14. Provide benefits, services, and instructional materials in a manner that may be easily understood;
15. Provide information that describes the availability of supports and services and how to access them;
16. Provide information and help in the language or format of the patient's choice;
17. Provide interpreter services free of charge for non-English languages as needed;
18. Provide written materials in alternative formats and information on how to obtain them if the patient is visually or hearing impaired or has limited reading proficiency;
19. Provide information within a reasonable time after enrollment;
20. Provide information on services that are not covered on a moral /religious basis;
21. Provide information on how to access 911, emergency, and post-stabilization services as needed;
22. Provide information on how to obtain referrals for specialty care and other benefits that are not provided by METRO EAST;
23. Provide information on how and where to access benefits that are not covered under METRO EAST's Medicaid contract and may be available under the state health plan, including transportation;
24. Provide information on the grievance, appeal and fair hearing processes;
25. Actively listen to complaints and requests regarding care and services provided;
26. Provide the patient with timely written notice of any significant State and provider network-related changes;
27. Make recommendations regarding the METRO EAST member rights and responsibilities.

The Patient’s Responsibilities
To keep appointments as scheduled or phone in advance to cancel;

1. To follow treatment planning or ask for a review of your plan;
2. Let your therapist know of any changes in your condition, including any side effects of medication;
3. To seek help in times of crisis;
4. To keep violence, drugs, abusive language, and damaging behavior away from the treatment setting in 5. respect for others;
6. To be aware of program rules and abide by them;
7. To be an active participant in your treatment;
8. To ask questions if you do not understand;
9. To share with staff your experience of our services, what we do well, and what we could do better;
10. To provide, to the best of your knowledge, accurate and complete information regarding your medical history, including present and past illnesses, medications, hospitalizations, etc., to METRO EAST and its practitioners and providers to provide care;
11. Follow your treatment plan of care and instructions. The care plan is to be agreed upon by you and your assigned counselor; and a medical doctor.
To ask questions about your care. This will help you understand your health problems and develop mutually agreed-upon treatment goals to the degree possible.
12. Follow all MDHHS procedures for the required annual Medicaid enrollment and inform METRO EAST of any changes in insurance status.

METRO EAST Responsibilities

1. To provide quality behavioral health services;
2. To assess and evaluate behavioral health requests promptly;
3. To give you a choice of providers to the extent that is possible;
4. To offer you a second opinion if you request one;
5. To provide you with information about your behavioral health services and your rights;
6. To provide you with a written Notice of Action when advising you of termination, reduction, denial, suspension, or limit the authorization of services that you have requested and have been receiving;
7. To provide you with information about METRO EAST operations, organizational structure, annual reports, etc. upon request and to notify you annually that this information is available;
8. To protect the rights of individuals receiving services;
9. We are required by law to maintain the privacy and security of your personal health information;
10. To let you know promptly if a breach occurs that may have compromised the privacy or security of your data. We must follow the duties and privacy practices described in the notice of Privacy Practices and give you a copy;
11. Do not use or share your information other than as described in the Notice of Privacy Practices unless you tell us we can get it in writing;
12. You can change your mind at any time about the sharing of information, but this request should be made in writing to ensure it is documented in your request.
13. Provide you with written notice of any significant State and Provider network changes at least 30 days before the intended effective date of the change.
14. Make a good faith effort to give you a written notice of termination of your Service Provider within 15 days of receipt or issuance of a termination notice.



Metro East expects each patient to succeed. Success is measurable and directly tied to motivation, engagement, and commitment to change.

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