PATIENT RIGHTS

AAMG is dedicated to providing quality patient care. As a patient of AAMG, you will receive:

• Courteous, considerate, and respectful treatment at all times.

• Candid discussions of appropriate or medically necessary treatment options for your condition(s), regardless of cost or benefit options.

• The right to accept or refuse medical or surgical treatment.

• Access to preventive health care services and emergency care.

• Information about benefits, where and how to seek care, and the risks involved in treatment.

• Timely response to requests for services, inquiries, and complaints.

• Second opinions when medically appropriate.

• Titles and specialties of the health care professionals responsible for your care and the right to change to another doctor if you are not satisfied.

• Continuity of care if your doctor leaves your plan and you meet certain conditions.

• Health care services in a language you can understand and in a culturally-sensitive way.

• Privacy and confidentiality regarding your medical and health conditions.

• The right to receive a copy of your medical records and to add your own notes to your records.

• Information regarding the medical group and health plan grievance procedures.

• The right to request an Independent Medical Review of a decision your health plan or medical group makes about your care.

• Recognition of your rights to make decisions regarding your medical care, and to complete an Advanced Directive, thereby extending your rights to any person who may make decisions on your behalf regarding your medical care.

• The right to make recommendations to your patient rights and responsibilities.

• The right to report suspected instances of fraud, waste, or abuse of rights by any AAMG health care professionals to our Compliance Hotline at (415) 216-0088.

• Utilization management decisions made based only on the appropriateness of care, services and existence of coverage. AAMG does not offer financial incentives for individuals, practitioners, or staff for issuing denials of coverage, service, or care resulting in over- or under-utilization.

Patient Responsibilities

As your health care partner, we ask that you:

• Provide professional staff with all pertinent and up-to-date health care information needed to ensure the best possible medical outcome.

• Communicate with your primary care physician (PCP) when you have questions or concerns about your health.

• Adhere to instructions and guidelines given for health care services.

• Cooperate with health care professionals providing services to you, except in those instances when you have exercised your right to refuse services.

• Assume responsibility for being aware of your health benefits and services and how to correctly obtain them.

If you have any questions about your rights and responsibilities, please call our Member Relations Department at (415) 590-7418 or at our toll free number at (888) 227 - 2671. You may also contact your health plan's member services department using the phone number provided on your member identification card provided by your health plan.

Grievances

The California Department of Managed Health Care (DMHC) is responsible for regulating health care service plans. If you have a grievance against your health plan, you may first telephone your health plan and use your health plan’s grievance process.  Utilizing this grievance procedure does not prohibit any potential legal rights or remedies that may be available to you. If you need help with a grievance involving an emergency, a grievance that has not been satisfactorily resolved by your health plan, or a grievance that has remained unresolved for more than 30 days, you may call our Member Relations Department at (415) 590 - 7418 or at our toll free number at (888) 227-2671 for assistance.

State Fair Hearing

Disclaimer

Information on this website is provided by AAMG as a service to the public. AAMG expressly disclaims any implied warranty or representation about its accuracy or completeness, or appropriateness for any particular purpose, although we will try to keep the information as accurate as possible. Information on this site may be changed or updated without notice. The user assumes full responsibility for using the information at this site, and agrees that AAMG is neither responsible nor liable for any claim, loss, or damage resulting from its use. The content of this web site is for informational purposes only and should not be construed as professional medical advice or used for diagnosis, treatment or for medical care of any kind. Please consult with your physician regarding any medical questions you may have. The mention of specific products or services at this site does not constitute or imply a recommendation or endorsement by AAMG, unless it is explicitly stated.

This site also includes links to other Internet sites. The inclusion of these links is merely for your convenience and does not reflect the opinion of AAMG.

Your use of this site is also subject to all additional disclaimers and caveats that may appear throughout the site.