In order to receive optimal benefit from your prescription coverage, we would like to inform you of your rights and responsibilities:
Your Rights
- You have the right to know about the philosophy and characteristics of the patient management program.
- You have the right to have personal health information shared with the patient management program only in accordance with state and federal law.
- You have the right to identify the program’s staff members, including their job title, and to speak with a staff member’s supervisor if requested.
- You have the right to speak to a health professional.
- You have the right to receive information about the patient management program.
- You have the right to receive administrative information regarding changes in, or termination of, the patient management program.
- You have the right to decline participation, revoke consent, or disenroll at any point in time.
- You have the right to know that because you have a pharmacy benefit from your insurer, you have the right to access prescription services, regardless of sex, age, sexual orientation or preference, ethnicity, national origin, religion, veteran status, lifestyle, genetic information, or disability.
- You have the right to participate in decisions regarding your care.
- You have the right to participate in the development and periodic revision of plan of care.
- You have the right to receive information in a manner in which you can understand and be able to give informed consent to the start of any procedure or treatment.
- You have the right to be informed of any responsibilities you may have in the care process.
- You have the right to know our telephone number for easy access to our staff.
- You have the right to know the name of the employee with whom you are talking and their job title.
- You have the right to let us know of any issue or concern you may have regarding our services by calling our telephone number. We will respond to your concern within five business days or sooner depending on the problem.
- You have the right to expect that Sunray Drugs Specialty will process your prescriptions without undue delay and contact you in the event of any drug recall. Sunray Drugs Specialty personnel will call you on these issues and explain our plan to remedy the situation.
- You have the right to receive education or clinical advice from our pharmacist regarding a prescription. We offer you that option at the time your prescription is being delivered or you may call us at (888) 260-9555.
- You have the right to be informed, both orally and in writing, in advance of care being provided, of the charges, including payment for care/service expected from third parties and any charges for which the patient will be responsible.
- You have the right to receive information about the scope of services that the organization will provide and specific limitations on those services.
- You have the right to refuse care or treatment after the consequences of refusing care or treatment are fully presented.
- You have the right to be informed of patient rights under state law to formulate an Advanced Directive, if applicable.
- You have the right to have one’s property and person treated with respect, consideration, and recognition of patient dignity and individuality.
- You have the right to be free from mistreatment, neglect, or verbal, mental, sexual, and physical abuse, including injuries of unknown source, and misappropriation of patient property.
- You have the right to voice grievances/complaints regarding treatment or care, lack of respect of property, or recommend changes in policy, personnel, or care/service without restraint, interference, coercion, discrimination, or reprisal.
- You have the right to have grievances/complaints regarding treatment or care that is (or fails to be) furnished, or lack of respect of property investigated.
- You have the right to understand how to report complaints/grievances and how these are investigated and resolved.
- You have the right to confidentiality and privacy of all information contained in the patient record and of Protected Health Information.
- You have the right to be advised on Sunray Drugs Specialty’s policies and procedures regarding the disclosure of clinical records.
- You have the right to receive appropriate care without discrimination in accordance with physician orders, if applicable.
- You have the right to be informed of any financial benefits when referred to an organization.
- You have the right to be fully informed of one’s responsibilities.
Your Responsibilities
- You have the responsibility to submit any forms that are necessary to participate in the program, to the extent required by law.
- You have the responsibility to give accurate clinical and contact information, and to notify the patient management program of changes in this information.
- You have the responsibility to notify your treating provider of their participation in the patient management program, if applicable.
- You have the responsibility to assure a continuous supply of medications and related supplies necessary for administration to avoid interruption in treatment.
- You have the responsibility to fulfill the financial obligations of your health insurance benefit plan so that any co-pays required for your medication are paid on time to avoid delays in scheduled doses of your medication. If you develop any financial difficulties, please let us know so we may refer you to programs that offer assistance.
- You have the responsibility to become knowledgeable about your medications by reading the information we send you each time we deliver the drug or by calling us at (888) 260-9555. Knowledge about your medications includes knowing the risks for taking the drug and reporting to us any side effects you might be experiencing.
- You have the responsibility to notify Sunray Drugs Specialty of any concerns about the care or services provided.