You have the right to:
- Receive a copy of our HIPAA “Notice of Privacy Practices” and “Patient’s Bill of Rights & Responsibilities”.
- Treatment with respect, consideration, and dignity.
- Receive health services without discrimination based on race, color, religion, gender, national origin, or payer. Our practice is not required to provide uncompensated or free care and treatment unless otherwise required by law.
- Personal privacy and confidentiality of medical care and medical records.
- Information regarding diagnosis, treatment, and alternatives to make informed decisions.
- Ask any questions and to expect a clear and honest answer.
- Be informed of the training and credentials of your physician.
- Participate in health care choices & make informed decisions regarding your patient care.
- Refuse treatment and learn the medical consequences.
- Review information, request an amendment, and receive copies of medical records.
- Seek a second opinion, or change primary physician, if desired or requested.
- Freedom from abuse, neglect, exploitation, harassment or discrimination.
- Receive surgical services in a safe setting.
- Be informed of fees and payment policies.
- Be informed that observers are not allowed in the operating room.
- Be subjected to accurate marketing to reflect the competence and capabilities of our organization.
- Formulate advance directives and have your physician and staff comply with these directives.
- Be evaluated for services available at our organization.
- Provisions for after-hours and emergency care.
- Refuse participation in experimental research.
- Receive written notice of physician ownership & financial interest in Surgi-Suite. (Drs. Edney, Bruneteau & Montag).
- Receive verbal and written notice of your patient rights.
- Make informed decisions regarding advanced directives care, including policies and state laws if requested.
- Voice any grievance regarding treatment or care that is or fails to be provided & methods for providing feedback.
- Be informed that interpretation services are available.
Express compliments and suggestions, as well as complaints or grievances without reprisal and expect redress to: Rita Petersen, R.N., Practice Administrator of Surgi-Suite and Aesthetic Surgical Images (402) 408-0700 or rita@surgicalimages.com.
Inform the following governmental agencies of your complaint: DHHS division of Public Health Investigations, P.O. Box 5986 Lincoln, Ne. 68509 (402) 471-0316 or Office of Medicare Beneficiary Ombudsman: www.medicare.gov 1-800- Medicare.
You have the responsibility to:
- Provide complete and accurate personal health information.
- List all current medications, including over-the-counter products, dietary supplements, and any allergies or sensitivities.
- Question us until the recommended procedure is fully understood.
- Cooperate fully in the treatment program you and your doctor have agreed to.
- Keep your appointments or reschedule in advance.
- Make appropriate arrangements for the payment of your account.
- Inform us of advance directives, living will, or medical power of attorney before surgery.
- Follow all patient care instructions as directed.
- Arrange a responsible adult caregiver for the first 24-48 hours after surgery.
- Contact us if concerns or questions arise.
- Adhere to COVID-related policies and procedures.
- Provide an English-speaking interpreter for all communication with our office (i.e., consultation, pre-operative appointment, surgery day, initial follow-up appointments, and after-hours emergency care).
- Be respectful towards all healthcare professionals and staff as well as other patients and visitors.