Chronic Care/Disease Management Patient Bill of Rights and Responsibilities

When you participate in a Chronic Care/Disease Management (DM) program, you have certain rights and responsibilities.

You have the right to:

• Know the philosophy and characteristics of the DM program.
• Have personally identifiable health information shared by the DM program only in accordance with state and federal law.
• Know the identity and job title of staff members and speak with a supervisor upon request.
• Receive accurate information from the DM program.
• Receive DM program information based on individual needs and preferences.
• Receive administrative information regarding changes in or termination of the DM program.
• Decline participation, revoke consent, disenroll, or submit a complaint at any point in time.

You have the responsibility to:

• Submit any forms that are necessary to participate in the DM program to the extent required by law.
• Give accurate clinical and contact information and notify the DM program of changes in this information.
• Follow an agreed upon plan to address targeted clinical conditions, comorbidities and risk factors.
• Notify your treating provider of your participation in the DM program.
• Provide input on experiences, care and services related to the DM program.