SUMMARY OF THE PATIENT’S BILL OF RIGHTS AND RESPONSIBILITIES

Florida law requires that your health care provider or health care facility recognize your rights when you are receiving medical care and that you respect the health care provider’s or health care facility’s right to expect certain respectful behavior on the part of patients towards all healthcare professionals as well as staff and other patients. You may request a copy of the full text of this law from your health care provider or health care facility.

A summary of your rights and responsibilities follows:

  • A patient has the right to be treated with consideration, courtesy and respect, with appreciation of his or her individual dignity and with protection of his or her need for appropriate privacy in a safe setting.
  • A patient has the right to a prompt and reasonable response to questions and requests.
  • A patient has the right to know who is providing medical services, who is responsible for his/her care, and the credentials of the health care professionals.
  • A patient has the right to know what patient support services are available, including whether an interpreter is available if he or she does not speak English.
  • A patient has the right to know what rules and regulations apply to his or her conduct.
  • A patient has the right to be given by his health care provider information concerning diagnosis, evaluation, planned course of treatment, alternatives, risks and prognosis. When it is medically inadvisable to give such information to a patient, the information is provided to a person designated by the patient or to a legally authorized person.
  • A patient has the right to be fully informed about a treatment or procedure and the expected outcome before it is performed.
  • A patient has the right to refuse any treatment, except as otherwise provided by law.
  • A patient has the right to be given, upon request, full information and necessary counseling on the availability of known financial resources for his or her care.
  • A patient who is eligible for Medicare has the right to know, upon request and in advance of treatment; whether the health care provider or health facility accepts the Medicare assignment rate.
  • A patient has the right to receive, upon request, prior to treatment, a reasonable estimate of charges for medical care.
  • A patient has the right to information regarding payment policies and to receive a copy of a reasonably clear and understandable itemized bill and upon request, to have the charges explained.
  • A patient has the right to impartial access to medical treatment or accommodations, regardless of race, national origin, religion, handicap, or source of payment.
  • A patient has the right to treatment for an emergency medical condition that will deteriorate from failure to provide treatment.
  • A patient has the right to information regarding provisions for after-hours and emergency care.
  • A patient has the right to know if medical treatment is for purposes of experimental research and to give his or her consent or refusal to participate in such experimental research.
  • A patient has the right to express grievances regarding any violation of his/her rights, as well as treatment or care that is (or fails to be) furnished, as stated in Florida law, through the grievance procedure of the health care provider or health care facility which served him or her and to the appropriate state licensing agency.
  • A patient has the right to information regarding methods for providing feedback, including complaints.
  • A patient has the right to change his/her provider if other qualified provider(s) is/are available.
  • A patient has the right to exercise his or her rights without being subjected to discrimination or reprisal.
  • A patient has the right to be free from all forms of abuse or harassment.
  • A patient has the right to be appropriately informed regarding the absence of malpractice insurance coverage.
  • A patient has the right to written information concerning FOISC’s policies on advance directives, including a description of applicable state health and safety laws and, if requested, official State advance directive forms, as well as information regarding the patient’s right to make informed decisions regarding the patient’s care.
  • A patient is responsible for providing to the healthcare provider, to the best of his or her knowledge, accurate and complete information to the best of his/her ability about present complaints, past illnesses, hospitalizations, medications, including over-the-counter products and dietary supplements, allergies or sensitivities, and other matters relating to his or her health.
  • A patient is responsible for reporting unexpected changes in his or her condition to the health care provider.
  • A patient is responsible for reporting to the health care provider whether he or she comprehends a contemplated course of action and what is expected of him or her.
  • A patient is responsible for following the treatment plan recommended by the health care provider and participate in his/her care.
  • A patient is responsible for keeping appointments and, when he or she is unable to do so for any reason, for notifying the health care provider or health care facility.
  • A patient is responsible for his or her actions if he or she refuses treatment or does not follow the health care provider’s instructions.
  • A patient is responsible for assuring that the financial obligations of his or her health care are fulfilled as promptly as possible.
  • A patient is responsible for following health care facility rules and regulations affecting patient care and conduct.
  • A patient is responsible for ensuring that he/she provides a responsible adult to transport him/her home from the facility and remain with him/her for 24 hours, if required by his/her provider.
  • A patient is responsible for accepting personal financial responsibility for any charges not covered by his/her insurance.
  • A patient is responsible for informing his/her provider about any living will, medical power of attorney, or other directive that could affect his/her care.
  • A patient is responsible for being respectful of all the health care professionals and staff, as well as other patients.
  • If a patient is adjudged incompetent under applicable state laws by a court of proper jurisdiction, the rights of the patient are exercised by the person appointed under state law to act on the patient’s behalf. If a state court has not adjudged a patient incompetent, any legal representative or surrogate designated by the patient in accordance with state law may exercise the patient’s rights to the extent allowed by state law.
  • A patient receiving care in a health care facility or in a provider’s office has the right to bring any person of his or her choosing to the patient accessible areas of the healthcare facility or provider’s office to accompany the patient while the patient is receiving inpatient or outpatient treatment or is consulting with his or her health care provider, unless doing so would risk the safety or health of the patient, other patients, or staff of the facility or office or cannot be reasonably accommodated by the facility or provider.

For Billing Questions:

Collections Department
(813) 972-4905; option 3, then option 6
13060 N Telecom Parkway, Temple Terrace, Florida 33637
For Billing Disputes:

Michelle Jones (Business Office Director)
(813) 972-4905 ext. 6611
13060 N Telecom Parkway, Temple Terrace, Florida 33637

Submission and Investigation of Grievances:

Heather Steel (Quality Assurance Manager)
(813) 972-4905 ext. 6513
Email – hsteel@floridaortho.com
13060 N Telecom Parkway, Temple Terrace, Florida 33637
Submission and Investigation of Identifiable Health and Privacy Information Violations:

Michelle Jones (HIPAA Compliance and Privacy Officer)
(813) 972-4905 ext. 6611
Email – Mjones@floridaortho.com
13060 N Telecom Parkway, Temple Terrace, Florida 33637

STATE AND FEDERAL FILING OF COMPLAINTS

(HOSPITALS) – AGENCY FOR HEALTH CARE ADMINISTRATION
Complaint Administration Unit
2727 Mahan Drive Mailstop 49
Tallahassee, FL 32308
1-888-419-3456 (Press 1)

(HEALTHCARE PROFESSIONALS) – Medical Quality Assurance
Florida Department of Health
Consumer Services Unit
4052 Bald Cypress Way C-75
Tallahassee, FL 32399
1-888-419-3456 (Press 2)

MEDICARE PATIENTS

Medicare Beneficiary Ombudsman:
http://www.medicare.gov/claims-and-appeals/medicare-rights/get-help/ombudsman.html
1-800-633-4227

File a Quality of Care Complaint:
FMQAI: Beneficiary Complaints
5201 West Kennedy Blvd. Suite 900
Tampa, Florida 33609
1-800-844-0795