Member Rights and Responsibilities
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It is the responsibility of Blue Cross and Blue Shield of Kansas (BCBSKS) and its contracting providers to treat you and/or members of your family in a manner that acknowledges and supports your basic human rights.
As a BCBSKS member, you have the following rights and responsibilities:
| You have the right to... | You have the responsibility to... |
|---|---|
| Considerate and courteous care, with respect for personal privacy and dignity. | Treat BCBSKS personnel respectfully and courteously as partners in good health care. |
| Select your own physician. | Develop a physician-patient relationship based on trust and cooperation. |
| Request a directory of BCBSKS contracting providers. | Understand the benefit differences when utilizing out of network providers. |
| Participate in the health care process with the professionals who can help you take charge of your health and you have the right to say no to any treatment. | Maintain your health and prevent illness by making positive health choices and seeking appropriate care when needed. |
| Reasonable access to appropriate medical services. | Keep scheduled appointments or give adequate notice of delay or cancelation and to notify BCBSKS if you are unable to access appropriate medical services. |
| Receive the benefits of your BCBSKS membership and to be informed of available services, as well as where, when, and how you can obtain these services. | Read all BCBSKS materials carefully and immediately upon your enrollment and to ask questions when necessary. |
| Receive assistance when language barriers exist between you or a member of your family and BCBSKS or a provider of service. | Notify BCBSKS promptly of any changes affecting your membership and to remit premiums by the due date. |
| Your personal information and health records to be kept confidential except when disclosure is required by law. | Advise your physician and/or BCBSKS when you require assistance due to a language barrier. |
| Express a complaint and to receive an answer to the complaint within a reasonable period of time. | Help maintain accurate and current records by being honest and complete when providing information to BCBSKS and/or health care professionals. |
| Appeal adverse benefit decisions and to receive the documentation used to make the decision. | Express your concerns or complaints in a constructive manner to the appropriate people at BCBSKS. |
| Receive prompt and accurate claims payment. | Make timely appeals in the proscribed manner. |
| Make payment for copayments, deductibles and coinsurance as listed in your certificate. |