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Patient and Provider Responsibilities

Patient and Provider Responsibilities

Your commitment to a patient-centered Medical Home will provide you with expanded and more coordinated care. Your physician will work with both you and your other health care providers, as a team, to take care of you. You will also have greater access to your physician through extended hours, telephone access, and/or Internet communication.

Medical Home Network Patient Responsibilities

  • Partner with the physician/staff in establishing collaborative relationships that address personal health and health behavior issues.
  • Keep scheduled appointments or cancel as far in advance as possible, and meet financial obligations in accordance with your benefit plan.
  • Have wellness screenings that are appropriate for your age, gender, and/or condition.
  • Understand your health condition to stay as healthy as possible: ask questions about your care and tell the team when you don’t understand something.
  • Follow the plan that you have agreed is best for your health.
  • Call if you do not receive your test results within two weeks.
  • Contact the Medical Home after hours only if your issue cannot wait until the next business day.
  • If possible, contact your selected Medical Home before going to the emergency room, so someone who knows your medical history can care for you.
  • Communicate changes in your health and/or condition to your personal physician to keep medical records up-to-date, including information on over-the-counter medications and dietarysupplements (such as vitamins, herbal supplements, etc.).
  • Contact your personal physician first for all medical issues, other than situations perceived to be life-threatening emergencies or with potential to permanently impair health status. Your personal physician will assist with determining the appropriate health care provider to meet your health care needs, unless you are already under the care of a specialist.
  • Take medicine as prescribed by your physician.
  • Report any hospitalizations or emergency room visits to your personal physician.
  • Report specialty physician and other visits, with results from those visits, to your personal physician.
  • Acknowledge that your personal physician will receive all information related to your health and medical care.
  • Communicate with Blue Cross Blue Shield of Texas to understand your health plan benefits.
  • Participate in and make decisions about your own care and pain management. This includes refusing care to the extent permitted by law based on physicians and other practitioners explaining the medical consequences of refusing recommended treatment.
  • Have illnesses, treatment plans, pain management, treatment alternatives, and expected outcomes explained in an understandable manner with interpretation services as needed.

Medical Home Network Provider Responsibilities

  • Create a trusting, collaborative relationship with you and your family to ensure that the patient’s health care needs are met.
  • Treat you with compassion and understanding.
  • Learn about you, your family, life situations, and health goals. Your personal physician will collect this information and suggest treatments that make sense for you.
  • Communicate clearly with you so you understand your condition(s) and all your options, and help you make the best decisions for your care.
  • Use evidence-based medicine and clinical decision support tools to guide decision making at the point of care, based on your specific factors.