Patient Bill of Rights
- The patient has the right to be treated with consideration, respect and dignity.
- The patient and/or the patient representative has the right to all complete and current information concerning his/her diagnosis and treatment and in terms that he/she can understand.
- The patient has the right to know the person or persons responsible for coordinating his/her care. If not medically advisable to give information to the patient, the information shall be made available to an appropriate person on the patient’s behalf.
- The patient has the right to receive from the physician enough information so that he/she may understand the services being rendered in order to sign the informed consent.
- The patient has the right to refuse treatment and to be informed of the consequences of his/her actions.
- The patient has the right to privacy of any information or treatment concerning his/her own medical care.
- The patient has the right to be informed of any persons other than routine personnel that would be observing or participating in his/her treatment and to refuse that observation and/or participation.
- The patient has the right for all medical records to be treated as confidential and given the opportunity to approve or refuse his/her release unless it would cause a negative outcome in the continuation of medical care.
- The patient has the right to information concerning the facility to which he/she may have to be transferred. The facility that the patient is to be transferred to must give approval prior to the patient transfer.
- The patient has the right to know if any research will be done during his/her treatment and has the right to refuse it.
- The patient has the right to expect quality care and service from the Surgery Center at Pelham (SCP).
- The patient has the right to examine and receive an explanation of his/her bill, regardless of the source of payment.
- The patient has the right to know, in advance, the expected amount of his/her bill regardless of the source of payment.
- The patient has the right to know what SCP rules and regulations apply to his/her conduct as a patient.
Advance Directives
POLICY
- Advance directives regarding resuscitation are not honored at this facility.
- Patients are informed at the time of the pre-admission visit or admission that the facility does not honor advanced directives regarding resuscitation. In all instance of emergency or life-threatening situations, life-sustaining treatment (including resuscitative services) will be instituted and patients transferred to a higher level or care.
- Upon transfer to the hospital, a copy of the Advance Directive will follow the patient. The directive will be followed once the patient reaches the higher level of care.
ADVANCED DIRECTIVES WEBSITE
You may obtain more information by clicking here or visiting our front desk.
Your Rights and Protections Against Surprise Medical Bills
When you get treated by an out-of-network provider at an in-network ambulatory surgical center, you are protected from surprise billing or balance billing.
What is “balance billing” (sometimes called “surprise billing”)? When you see a health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.
“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay, and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.
“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.
You are protected from balance billing for: When you get services from an in-network ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to, anesthesia, pathology, radiology, laboratory, assistant surgeon. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.
You’re never required to give up your protections from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network.
When balance billing isn’t allowed, you also have the following protections:
• You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.
• Your health plan generally must:
o Base what you owe the provider or facility (cost-sharing) on what it would pay an in network provider or facility and show that amount in your explanation of benefits.
o Count any amount you pay for out-of-network services toward your deductible and out-of-pocket limit.
If you believe you’ve been wrongly billed, you may contact http://www.cms.gov/nosurprises/consumers
email: [email protected], or call 1-800-985-3059.
Visit CMS.gov/nosurprises/consumers, for more information about your rights under federal law.
Quality Indicator |
Explanation |
QT 1 2023 |
QT 2 2023 |
QT 3 2023 |
QT 4 2023 |
Year End 2023 |
Benchmark |
| Rate of Hospital Transfers/admissions (including OBS or hospital emergency room) upon discharge from the ASC. | Provide number of patients requiring hospital transfer or admissions (including OBS or hospital ED) upon d/c from ASC | 1 | 2 | 3 | 1 |
7 0.1% |
No greater than reported by the national quarterly mean |
| Number of admissions (patients) who experience a burn prior to discharge | Provide number of patients who experience a burn prior to discharge |
0%
|
0% |
0% |
0% |
0% |
No greater than 0% |
| Number of admissions (patients) who experience a fall prior to discharge | Provide the number of patients who experience a fall within the ASC |
0
|
0 |
0 |
0 |
0 |
No greater than reported by the national quarterly mean |
| Rate of ASC admissions (patients) who experience a wrong site, side, patient, procedure or implant | Provide the number of patients who experience a wrong site, side, patient, procedure or implant |
0
|
0 |
0 |
0 |
0 |
No greater than 0% |
| Degree of Patient Satisfaction in the service provided to the patients | Provide the patient satisfaction percentage based on positive survey feedback |
100%
|
100% | 100% | 99% | 99% |
95% or greater |