Rights & Responsibilities
It’s important for you to know and understand your rights as well as the things for which you are responsible.
Your Rights and Responsibilities
You have rights as a member of Colorado Access. Your rights are important and you should know what those rights are. Please call us if you have questions. We want to help you understand your rights. We want to make sure you are being treated fairly. Exercising your rights will not negatively affect the way we treat you. It will also not negatively affect how our network providers treat you.
Your Rights
You have the right to:
- Respect and consideration for your dignity and privacy. Your personal information will only be released to others when you give your permission or it is allowed by law.
- Covered health care services from any provider in our network. You can ask us to add a provider to our network.
- Information about Colorado Access, our services and providers, your benefits, and your rights and responsibilities.
- Prompt notice of any changes in benefits, services, or providers.
- Information in your language and in a way you can easily understand.
- Services from a provider who speaks your language, or access to free interpretation services.
- Access to care when within timely appointment standards.
- Care for emergency conditions from any provider, in- or out-of-network, 24 hours a day, seven days a week.
- Honest and clear discussions of your condition and treatment, including:
- The condition and diagnosis
- Available treatments and what is best for you, regardless of cost or benefit coverage
- What to expect from treatment
- Your own decisions about your care, including the decision to refuse or stop treatment, except as provided by law.
- A second opinion on your diagnosis or treatment.
- Advance notice of any fees you may be charged.
- Freedom from any kind of restraint or seclusion to punish you or force you to do something, or to make things easier for your provider.
- Written notice of any decision we make to deny or limit services.
- File complaints or appeals about Colorado Access, its providers, or decisions about your care.
- Copies of your medical records and requests to have them changed or corrected.
- Use your rights without being treated poorly.
- Request changes to our member rights and responsibilities policy.
- Other rights guaranteed by law.
Your Rights
Get a full explanation from providers about:
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- You or your child’s health diagnosis and condition
- Different kinds of treatment that may be available
- What treatment and/or medication might work best
- What you can expect
- Take part in talks about what you need. Make decisions about your health care with your providers.
- Get a second opinion if you have a question or disagreement about your treatment.
- Be notified promptly of any changes in benefits, services or providers.
- Refuse or stop treatment, except provided by law.
- Not be secluded or restrained as punishment or to make things easier for your provider.
- Ask for and get copies of your medical records. You can also ask that they be changed or fixed.
- Get written information about advance medical directives.
- Get information about the grievance, appeal, and fair hearing procedures. You can also get help with this.
- Use your rights without fear of being treated poorly.
- Have your privacy respected. Your personal information can only be released to others when you give your permission or when it is allowed by law.
- Know about the records kept on you while you are in treatment. Also know who may access your records.
- Any other rights guaranteed by law.
Your Responsibilities
- Use providers in our network.
- Follow our rules and the rules described in your member handbook for Child Health Plan Plus or Health First Colorado (Colorado’s Medicaid program).
- Work with your providers and be respectful to other members, your providers, and our staff.
- Pay your copays.
- Pay for services we do not cover.
- Tell us if you have other health coverage, including Medicare. This also includes coverage from a claim or action against a third party responsible for your illness or injury.
- Keep your personal information updated.
- Keep scheduled appointments. Reschedule or cancel if you cannot make the appointment.
- Understand your health problems and participate in creating treatment goals, to the best of your ability.
- Give Colorado Access and your providers any information we need to provide care, to the best of your ability.
- Follow the plans and instructions for care that you and your providers have agreed to.
- Do your part for your care. Ask for support from friends, family, or the community when you need it.
Your Responsibilities
- Ask questions when you don’t understand.
- Ask questions when you want more information.
- Tell your providers information they need to care for you. This includes telling them your symptoms.
- Work with your providers to create goals that will help you in recovery or to stay healthy. Follow the treatment plans that you and your providers have agreed to.
- Take medications as prescribed. Tell your provider about side effects or if your medications are not helping.
- Seek more support services in the community.
- Invite people who will be helpful and support you to be a part of your treatment.
Member Code of Conduct
At Colorado Access, we treat members with respect and expect the same of you.
You may not abuse, threaten, or intimidate our staff. You also may not be offensive, insulting, or disruptive. We will not tolerate:
- Yelling and swearing.
- Lying or hiding the truth.
- Personal attacks or insults.
- Racist or prejudiced words.
- Words or actions that threaten, intimidate, or frighten.
- Harassment through repeated calls, emails, or visits for a problem or question we have already dealt with.
- Talking to our staff through their personal contact methods.
- Any other inappropriate words or actions. Our staff will decide what is inappropriate.
- Weapons on our property.
Member Code of Conduct
If we think you might put our staff or other members in danger, we may limit you from coming to our office. If needed, we may call the police to keep people safe at our office.
If you break this code of conduct, we will set up a communication plan. This plan will have:
- A point of contact.
- A timeframe.
- Expectations for communicating with us.
The communication plan does not limit your access to services. It also does not limit your access to care management. It will include accommodations for disabilities and languages other than English.