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Notice of Patient Rights & Responsibilities

Last Updated 11/04/2022

INFORMATION FOR PATIENTS: You have the right to accurate and easy-to-understand information about your health plan, healthcare professionals, and healthcare facilities. If you speak another language, have a physical or mental disability, or just don’t understand something, help will be provided so you can make informed healthcare decisions.

CHOICE OF PROVIDERS: As part of your individual plan of care at Midwest Express Clinic, you may be referred for additional evaluation, treatment or testing by other healthcare providers. Please be aware that you are the ultimate decision maker and have the right to choose your healthcare provider.

ACCESS TO EMERGENCY SERVICES: If you have severe pain, an injury, or sudden illness that makes you believe your health is in danger, you have the right to be screened and stabilized until emergency services arrive at our center using emergency services. You should be able to use these services whenever and wherever you need them, even if they’re out of your network, without needing to wait for authorization and without financial penalty from your insurance carrier.

TAKING PART IN TREATMENT DECISIONS: You have the right to be informed about your treatment options and take part in decisions about your care. You have the right to ask about the pros and cons of any treatment, including no treatment at all. As long as you are able to make sound decisions, you have the right to refuse any test or treatment, even if it means you might have a bad health outcome as a result. You can also choose someone who can speak for you if you cannot make your own decisions.

RESPECT AND NON-DISCRIMINATION: You have a right to considerate, respectful care from your healthcare providers and support staff that does not discriminate against you based on race, ethnicity, national origin, religion, sex, age, mental or physical disability, sexual orientation, genetic information or source of payment.

Privacy of health information: You have the right to privacy and to request confidential communications in a way that suits your needs. You have the right to request restrictions on how we may use your health information. You also have the right to read and copy your own medical record. You have the right to ask that your health care provider change your record if it’s not correct, relevant, or complete. You have the right to ask us for a list of disclosures of your PHI. You also have a right to a paper copy of our Notice of Privacy Practices which further discusses these privacy-related rights and informs you how we generally use your protected health information.

COMPLAINTS AND APPEALS: You have the right to a fair, fast, and objective review of any complaint you have against Midwest Express Clinic. This includes complaints about waiting times, operating hours, the actions of healthcare personnel, and the adequacy of health care facilities. If you have a complaint during your visit, please go to “Contact Us” on our website ( You also have the right to file a complaint with the state Department of Health Services.

CONSUMER RESPONSIBILITIES: In a healthcare system that protects consumer or patients’ rights, patients have certain responsibilities. For instance, patients have the responsibility to tell their healthcare providers about any drugs or supplements they are taking, any allergies or sensitivities they have, and about any other health conditions and medical or surgical problems in the past or present that affect their health. Patients must ask questions or request further information from healthcare providers if they do not completely understand health information and/or instructions they’ve been given. Patients must also take responsibility for their lifestyles to help improve their own health (for instance, following a treatment plan, exercising, and not using tobacco). Having patients involved in their care increases the chance of the best possible outcomes and helps support a high quality, cost-conscious health care system. Patients are also expected to do things like treat healthcare workers and other patients with respect, pay their medical bills, and follow the rules and benefits of their health plan coverage.

EFFECTIVE DATE: This notice is effective on 11/1/2022 and replaces all earlier version.

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