Ambulatory Surgery Center Patient Bill of Rights

病人的权利 will be exercised without regard to sex, 文化, 经济, 教育, or religious background or the source of his or her background or the source of payment for care.

患者可以预期:

• 体贴和尊重的关怀.
• 适当的隐私.
• Patient disclosures and individual medical records are confidential and secure, except when
  法律规定的报告目的. 病人 have the right to sign a waiver of release if they so
  选择.
• 病人 and/or a designated individual by the patient or legally responsible persons are provided, to
  the degree known, with complete information concerning diagnosis, evaluation, treatment and
  预后.
• 病人 are given the opportunity to participate in decisions involving their health care.
• Information is available to patients and staff regarding:
  • 病人的权利. 请参阅 第151:21节NH患者权利法案 网站.
  • 患者行为和责任.
  • Provisions for After Hours and Emergency Care. Please call the appropriate number below and the provider on call will respond:
    • 曼彻斯特: 603-695-2500
    • 纳舒厄: 603-577-4801
  • 服务费用-电话 800-238-0505.
  • For payment arrangements or to request financial assistance, call 844-808-0730.
  • Right to refuse to participate in experimental research.
  • 预先指令
  • Credentials of healthcare providers will be offered on request.
• 病人 have the right to change providers if another qualified provider is available.
• 病人 are informed about process of expressing suggestions, complaints, compliments, or
  不满.
• 联系病人关系，请拨打电话 603-629-1859.
• Patient has the right to be free of all abuse or harassment.
• Patient has the right to be fully informed about the treatment, procedure and expected outcome
  手术前.
• If a patient is adjudged incompetent under applicable state health and safety laws by the court, the
  rights of the patient are exercised by the person appointed under state law to act on the patient’s
  代表.
• If a court has not adjudged a patient as incompetent, any legal representative designated by the
  patient may exercise the rights of the patient to the extent allowed by law.
• A patient has the right to his or her rights without being subjected to discrimination or reprisal.
• 病人 have the right to 选择 another facility for their care.
• Our providers do not have a personal financial interest in the Ambulatory Surgery Center at Dartmouth Hitchcock Clinics Manchester.

病人的责任

患者必须:

• Give accurate information about medical conditions, medications (including over-the-counter products), 膳食补充剂和过敏.
• Follow the agreed-upon treatment plan recommended by your provider and participate in your care.
• Provide a responsible adult to transport you home and to remain with you as directed by your provider or as indicated on discharge instructions. You may not drive at all after a procedure if you have received sedation or anesthesia.
• 告知员工生前遗嘱, medical power of attorney or advance directive that could affect your care. It is advisable to have these documents scanned into the medical record for future use if needed. 欲了解更多信息，请访问我们的网站 预先护理计划 页面.
• Accept personal responsibility for charges not covered by insurance.
• Be respectful of all health care providers and staff, as well as other patients.
• Inform staff members of any special needs or accommodations that may be necessary.
• Be responsible for your actions if you refuse treatment or do not follow the provider’s instructions.

申诉政策和程序

If you believe that Dartmouth Hitchcock Clinics Manchester or Dartmouth Hitchcock Clinics Nashua has failed to provide these services or discriminated in another way based on race, color, 国家的起源, 年龄, 残疾或性别, 你可以提出申诉. Dartmouth Hitchcock Clinics Manchester and Dartmouth Hitchcock Clinics Nashua has adopted grievance procedures that provide for the prompt and equitable resolution of complaints.

To voice concerns or 不满 regarding your care, please contact:

Heather Long, Director of Perioperative 服务
Dartmouth Hitchcock Clinics Southern Region
希区柯克路100号
曼彻斯特NH 03101
603-629-1800

针对医疗保险和医疗补助病人

• All Medicare beneficiaries may file a complaint with the Medicare Beneficiary Ombudsman at 800-633-4227 或者写在 特派员中心.
• 医疗保险和医疗补助服务中心
  保安大道7500号
  巴尔的摩，马里兰州21244

如欲了解更多详情，请参阅 Dartmouth Hitchcock Medical Center and Dartmouth Hitchcock Clinics Patient Rights and Privacy 网页.