The “patient” refers to the patient, patient’s representative, or surrogate, if applicable.
AS A PATIENT OF THE OREGON CLINIC, YOU HAVE THE RIGHT TO:
- Receive all communications in a language and/or manner you understand. Interpreters will be provided when necessary. The Oregon Clinic provides aids and services to people with disabilities to communicate effectively with us, such as:
- Qualified sign language interpreters and language interpreters.
- Information written in several of the common languages in this city.
- If you believe that The Oregon Clinic has failed to provide these services or discriminated in another way based on race, color, national origin, age, disability, or sex:
- You can file a grievance with the Compliance Officer for The Oregon Clinic by mail at 541 NE 20th Ave, Suite 225, Portland, OR 97232; (fax) 503-935-8911; or email to [email protected].
- You can file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically at Filing a HIPAA Complaint | HHS.gov or by phone at 1-800-368-1019 (TDD) 800-537-7697. Complaint forms are available here. (fax) 202-619-3818.
- For concerns about The Oregon Clinic’s ambulatory surgical centers, contact the Oregon Health Authority, Health Care Regulation and Quality Improvement Program: 800 NE Oregon Street, Suite 465, Portland OR 97232; 971-673-0540. Complaint forms are available here.
- Considerate, respectful, and compassionate care in a safe and secure environment that is free of all forms of discrimination, abuse, or harassment. The Oregon Clinic complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.
- Exercise your rights without being subjected to discrimination or reprisal.
- Personal privacy and confidentiality concerning your medical care. Information can only be released with your consent, except as provided by law. You have the right to be advised as to the reason for the presence of any individual. HIPAA regulations will be observed.
- Receive information about your diagnosis, treatment, and expected result from your provider or designated staff in terms you can understand. When it is medically inadvisable to provide such information to a patient, the information is provided to a person designated by the patient or to a legally authorized person.
- Receive the necessary information and participate in decisions regarding a procedure or proposed treatment in order to give informed consent or to refuse this course of treatment.
- Reasonable continuity of care and to know, in advance, the time and location of appointment(s), as well as the practitioner providing the care.
- Consult with another physician or change providers if other qualified providers are available.
- Agree to or refuse to participate in research projects.
- Know the name and the professional status of the provider who has primary responsibility for coordination of your care and the names, professional relationships, and credentials of other practitioners and health care workers you may see.
- Within the confines of the law, review your medical records. All communications and records pertaining to your care will be treated as confidential.
- Receive information, in advance of a procedure, including a description of applicable State Health and Safety Laws, and if requested, official State advance directive forms. These are available upon request.
- Have in effect and documented on your medical record the presence of any Advance Directives concerning Living Wills, medical powers of attorney, or other documents that limit your care, and you have the right to be referred to an alternate facility if you wish to have your Advance Directives honored during your procedure. For further information, visit Oregon Health Authority : Advance Directive Advisory Committee (ADAC) : About the Public Health Division : State of Oregon. To access forms, visit: Oregon Health Authority : Advance Directive Forms : About the Public Health Division : State of Oregon.
- Provide appropriate feedback, including suggestions and complaints.
- Voice grievances, verbally or written, regarding treatment or care that is, or fails to be, furnished. For assistance in expressing grievances or complaints verbally or in writing visit Ombudsman Center | CMS or 1-800-MEDICARE, Oregon DHS: Oregon Department of Human Services : Complaints and Concerns : About Us : State of Oregon.
- Examine and receive an explanation of your bill and our payment policies, regardless of the source of payment.
- After-hours access to physician owners via phone. Emergency measures are available as needed.
Use the forms on the Patient Rights Forms page to request amendments to your medical record, restrictions on protected health information, or an accounting of protected health information disclosures.
AS A PATIENT OF THE OREGON CLINIC, YOU HAVE THE RESPONSIBILITY TO:
- Provide complete and accurate information about your health, including present condition, past illnesses, hospitalizations, medications, including over-the-counter products and supplements, allergies and sensitivities, and any other information that pertains to your health.
- Be an active participant in your care.
- Make it known whether you clearly comprehend a contemplated course of action and what is expected of you, including if you anticipate not following the prescribed treatment or are considering alternative therapies. Ask questions when you do not understand.
- Follow the treatment plan recommended by your practitioner, which may include the instructions of nurses and allied health personnel as they carry out the coordinated plan of care and implement the responsible practitioner’s orders, and as they enforce the applicable rules and regulations.
- Report unexpected changes in your condition to the responsible practitioner.
- Accept the responsibility for your actions if you refuse treatment or do not follow the practitioner’s instructions.
- Provide complete and accurate billing information for claim processing and to pay bills in a timely manner.
- Keep appointments, be on time for your appointments, and notify your physician as soon as possible if you cannot keep your appointments.
- Behave respectfully toward others and respect their property while in The Oregon Clinic facilities. Failure to comply with this may lead to termination from the practice.
- Review our Privacy Policy.
NOTICE OF REFERRAL RIGHTS
THIS NOTICE DESCRIBES YOUR REFERRAL RIGHTS WHEN YOUR HEALTH CARE PROVIDER REFERS YOU TO ANOTHER PROVIDER OR FACILITY FOR ADDITIONAL TESTING OR HEALTH CARE SERVICES.
In accordance with Oregon law, when you are referred for care outside of our clinic, we, The Oregon Clinic, are required to notify you that you may have the test or service done at a facility other than the one recommended by your physician or health care provider.
Oregon law says (ORS 441.098):
- A referral for a diagnostic test or health care treatment or service shall be based on the patient’s clinical needs and personal heath choices.
- A health practitioner or the practitioner’s designee shall provide notice of patient choice at the time the patient establishes care with the practitioner and at the time of the referral is communicated to the patient.
- The oral or written notice of patient choice shall clearly inform the patient:
- (a) That when referred, a patient has a choice about where to receive services; and
- (b) Where the patient can access more information about patient choice.
- The patient has a choice and when referred to a facility for a diagnostic test or health care treatment or service the patient may receive the diagnostic test or health care treatment or service at a facility other than the one recommended by the health practitioner.
- If the patient chooses to have the diagnostic test, health care treatment or service at a facility different from the one recommended by a practitioner, the patient is responsible for determining the extend of coverage or the limitation on coverage for the diagnostic test, health care treatment or service at the facility chosen by the patient.
- A health practitioner shall not deny, limit or withdraw a referral solely because the patient chooses to have the diagnostic test or health care treatment or service at a facility other than the one recommended by the health practitioner.
To listen to a recording of this Patient Rights and Responsibilities document, please call 503-935-8334.
(Revised 12/12/2023)
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