Patient Responsibilities and Rights

Alliance Community Healthcare is committed to providing you with the best available health care as efficiently as possible. You have certain rights in your relationship with health center personnel that are consistent with the laws of New Jersey State. 

• Understand and exercise these rights. If for any reason you need help to understand or exercise these rights, the Center MUST provide assistance, including an interpreter when necessary.
• Receive services without regard to age, race, color, religion, sex, national origin, disability, sexual orientation or source of payment.
• Receive considerate and respectful care ina clean, safe and smoke free environment.
• Be informed ofthe name of the provider in charge of your care at the Center. Be informed of the name and position of any other staff involved in your care and be able to refuse their involvement in your treatment.
• Receive complete information from the medical provider about your diagnosis and treatment, including an assessment of pain. Be informed about the need and understand the reason for any referral to another facility.
• Receive all the information you need to give informed consent forany proposed procedure or treatment.
• This information shall include the risks and benefits of the treatment or procedure.
• Refuse treatment and be told what effect this may have on your health.
• Refuse to take part in any research. In deciding whether or notto participate, you have the right to a full explanation.
• Privacy inthe Center and confidentiality of all information and records regarding your care.
• Participate inall decisions about your care.
• Access your medical record without charge and review the contents with your provider. Obtain a copy of your medical records, for which the Center may charge a reasonable fee; however, you cannot be denied a copy solely because you cannot afford to pay.
• Receive an itemized bill and explanation ofall charges.
• Complain without fear of reprisals about the care and services you are receiving and be given a written response if requested. If not satisfied with the response, you can complain to the New Jersey State Department of Health at Patient Safety at (800) 792 – 9770 or (609) 633-7759.
• Be informed of the services available at the Center.
• Know the provisions forafterhours care through the Center.
• Authorize or refuse to allow the disclosure of the contents of your medical record to any health care physician or health facility except as required by law or third-party payment contract.
• Make known your wishes regarding Advanced Directives and anatomical gifts. You may document your wishes in your health care proxy, available at the Center. If an emergency arises while at Alliance Community Healthcare, the staff will call “911” and arrange transportation to a hospital. If we have your Advanced Directives, we will forward them to the receiving hospital.
• Be informed about Alliance Community Healthcare’s rules and regulations regarding patient conduct at the Center.

• Keep your appointment. Arrive 15 minutes before your scheduled appointment time to complete paperwork and please understand that arriving late may result in your appointment being rescheduled.
• Be honest and complete about any information you give us. Please remember all information is confidential and can only be released with your written consent or disclosed under circumstances that are in accordance with state law.
• Be open about all aspects of your health and health care both past and present.
• To participate in medical services which may include lab tests and physical exam.
• Comply with the health center’s policy and procedures and follow instructions – if you do not understand please ask us to explain
• Ask questions – if something is confusing or unclear let us know – we are here to help you
• Pay your bill promptly so we can continue to provide quality care at low cost to all patients and provide information to ensure proper processing of insurance and payments
• Call us immediately if you need help
• Abide by the rules and regulations of patient conduct and responsibilities

or

• To keep appointments or call to reschedule
• To respect the personal rights and private property of other clients and staff
• To be honest with the information you give us
• To follow instructions
• To pay bills promptly so we can continue to help you
• To ask questions, and to inform us promptly if there are any changes in health