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LDI Integrated Pharmacy Services members have a right to be notified in writing of their rights and obligations before care/service has begun. LDI Integrated Pharmacy Services has an obligation to protect and promote the rights of their members to care, treatment and services within their capability and mission, and in compliance with applicable laws, regulations, and standards, including the following:

  • Be fully informed in advance about services/care to be provided, including the company representatives that provide care/services, and the frequency of visits as well as any modifications to the service/care plan.
  • Be treated, and have your property treated, with dignity, courtesy and respect, recognizing that each person is a unique individual.
  • Be able to identify company representatives through name and job title (name badge, wall picture, job title) and speak with a pharmacist or manager if requested.
  • Choose a healthcare provider.
  • Receive information about the scope of care/services that are provided by LDI Integrated Pharmacy Services directly or through contractual arrangements, as well as any limitations to the company’s care/service capabilities.
  • Receive upon request evidence-based practices information on clinical decision practices (manufacturer package insert, published practice guidelines, peer-reviewed journals, etc.) along with the level of evidence or consensus describing the process for intervention in instances where there is no evidence-based research, conflicting evidence, or no level of evidence.
  • Reasonable coordination and continuity of services from the referral source to LDI Integrated Pharmacy Services, timely response when care, treatment, services and/or equipment is needed or requested and to be informed in a timely manner of impending discharge.
  • Receive in advance of care/services being provided, complete verbal and written explanations of charges for care, treatment, services and equipment, including the extent to which payment may be expected from Medicare, Medicaid, or any other thirdparty payer, charges for which you may be responsible, and an explanation of all forms you are requested to sign.
  • Receive quality medications, infusion equipment, supplies and services that meet or exceed professional industry standards regardless of race, religion, political belief, sex, social or economic status, age, disease process, DNR status or disability in accordance with physician orders.
  • Receive medications, infusion equipment, treatment and services from qualified personnel and to receive instructions on self-care, safe and effective operation of equipment and your responsibilities regarding home care equipment and services.
  • Participate in decisions concerning the nature and purpose of any technical procedure that will be performed and who will perform it, the possible alternatives and/or risks involved and your right to refuse all or part of the services and to be informed of expected consequences of any such action based on the current body of knowledge.
  • Confidentiality and privacy of all the information contained in your records and of Protected Health Information (except as otherwise provided for by law or third-party payer contracts) and to review and even challenge those records and to have your records corrected for accuracy.
  • If desired, to be referred to other health care providers within an external healthcare system (ex. Dietitian, pain specialist, mental health services, etc.). Patient may also be referred back to their own prescriber for follow-up.
  • Receive information about to whom and when your personal health information was disclosed, as permitted under applicable law and as specified in the company’s policies and procedures.
  • Express dissatisfaction/concerns/complaints about any care/treatment or service, lack of respect of property and to suggest changes in policy, staff or care/services without discrimination, restraint, reprisal, coercion, or unreasonable interruption of care/services. Patients or caregivers can call (866) 516-2121 and ask to speak with a pharmacist or a member of management.
  • Have concerns/complaints/dissatisfaction about services that are (or fail to be) furnished, or lack of respect for property investigated in a timely manner.
  • Offered assistance with any eligible internal programs that help with patient management services, manufacturer co-pay and patient assistance programs, health plan programs (tobacco cessation programs, disease management, pain management, suicide prevention/behavioral health programs).
  • Be informed of any financial benefits when referred to an organization.
  • Be advised of any change in the plan of service before the change is made.
  • Participate in the development and periodic revision of the plan of care/service.
  • Receive information in a manner, format and/or language that you understand.
  • Have family members, as appropriate and as allowed by law, with your permission or the permission of your surrogate decision maker, involved in care, treatment, and/or service decisions.
  • Be fully informed of your responsibilities.
  • Have the right to decline participation, revoke consent or disenrollment in any LDI Integrated Pharmacy Services programs and services at any point in time.

I UNDERSTAND I HAVE THE RESPONSIBILITY TO:

  • Adhere to the plan of treatment or service established by your physician.
  • Adhere to LDI Integrated Pharmacy Services’ policies and procedures.
  • Submit any forms necessary to participate in the program, to the extent required by law.
  • Participate in the development of an effective plan or care/treatment/services.
  • Notify your treating provider of your participation in the patient management program.
  • Provide, to the best of your knowledge, accurate and complete medical and personal information necessary to plan and provide care/services.
  • Provide any necessary forms and documentation needed to participate in patient management programs, to the extent required by law.
  • Ask questions about your care, treatment and/or services, or to have clarified any instructions provided by LDI Integrated Pharmacy Services representatives.
  • Communicate any information, concerns and/or questions related to perceived risks in your services, and unexpected changes in your condition.
  • Be available at the time deliveries are made or notify LDI Integrated Pharmacy Services if you are going to be unavailable.
  • Treat company personnel with respect and dignity without discrimination as to color, religion, sex, or national or ethnic origin.
  • Provide a safe environment for LDI Integrated Pharmacy Services’ representatives to provide services.
  • Care for and safely use medications, supplies and/or equipment, according to instructions provided, for the purpose it was prescribed and only for/on the individual for whom it was prescribed.
  • Communicate any concerns about your/caregiver’s/family member’s ability to follow instructions or use the equipment provided.
  • LDI Integrated Pharmacy Services should be notified of any changes in your physical condition, physician’s prescription or insurance coverage. Notify LDI Integrated Pharmacy Services immediately of any address or telephone changes whether temporary or permanent.