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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:

  • Be treated with respect and consideration for your dignity and privacy.
  • Get health care services.
  • Ask for information about Colorado Access, our services and providers, including:
    • Your health benefits
    • How to access care
    • Your rights
  • Get information in a way you can easily understand.
  • Get information from your provider about treatment choices for your health needs.
  • Choose any provider in our network.
  • Get culturally appropriate and competent services from our providers.
  • Get services from a provider who speaks your language. Or get interpretation services in any language you need.
  • Ask that we add a specific provider to our network.
  • Get care that is medically necessary when you need it. This includes care 24 hours a day, seven days a week for emergency conditions.
  • Get emergency services from any provider, even those who are not in our network.
  • Get an appointment within the right standards. Those standards are listed here.
  • Know about any fees you may be charged.
  • Get written notice of any decision we make to deny or limit requested services.

Your Rights

Get a full explanation from providers about:

    • 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

You have the responsibility to:
  • Understand your rights.
  • Choose a provider in our network. Or call us if you want to see someone who is not in our network.
  • Follow our rules as well as the Health First Colorado (Colorado’s Medicaid program) or Child Health Plan Plus rules as described in the member handbooks.
  • Work with and be respectful to other members, your providers and staff.
  • Follow the steps to file a grievance or appeal with us when you need to.
  • Pay for any services that you get that we do not cover.
  • Tell us if you have other health insurance. This includes Medicare.
  • Tell us if you have changed your address.
  • Keep scheduled appointments. Call to reschedule or cancel if you cannot make the appointment.

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.

Download a copy here in English and here in Spanish.