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Network Matters
News and Information for the
Harvard Pilgrim Health Care Network

November 2017

Members’ Rights and Responsibilities


Harvard Pilgrim members receive a copy of the Members' Rights and Responsibilities upon enrollment, and all clinicians receive a copy at the time of contracting and credentialing and annually thereafter. Periodically, Harvard Pilgrim includes this information in Network Matters. Please take a moment to review. Because this information may vary among states, please be sure to read the full Rights and Responsibilities page of the Provider Manual.

Members have a right to:

  • Receive information about Harvard Pilgrim, its services, its practitioners, and providers, and members' rights and responsibilities
  • Be treated with respect and recognition of their dignity and right to privacy
  • Participate with practitioners in decision-making regarding their health care
  • Engage in a candid discussion of appropriate or medically necessary treatment options for their conditions, regardless of cost or benefit coverage
  • Voice complaints or appeals about Harvard Pilgrim or the care provided
  • Make recommendations regarding the organization’s members' rights and responsibilities policy

Members have a responsibility to:

  • Provide, to the extent possible, information that Harvard Pilgrim and its practitioners and providers need to care for them
  • Follow the plans and instructions for care that they have agreed upon with their practitioners
  • Understand their health problems and participate in developing mutually agreed-upon treatment goals to the degree possible

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Network Matters Archives

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HPHCURRENT EVENTS

Streamlining Provider Enrollment and Credentialing Processes

Webinar for Genetic Testing Authorization

2018 Star Ratings Measure Quality and Patient Satisfaction

CLINICIAN CORNER

Update: 3D Mammography Coverage

Update: Commercial Medical Transportation Policy

Members’ Rights and Responsibilities

PCPs and Behavioral Health Care Providers — Working Together

OFFICE ASSISTANT

Clarification on Inpatient Acute Medical Admissions Policy

Update to Evaluation and Management Payment Policy

Accident/Injury Questionnaire for Members

PUBLICATION INFORMATION

Eric H. Schultz,
President and Chief Executive Officer

Robert Farias,
Senior Vice President, Network Strategy

Annmarie Dadoly,
Editor

Joseph O'Riordan,
Writer

Kristin Edmonston,
Production Coordinator