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Member Rights and Responsibilities - Chapter 15, 2018 UnitedHealthcare Administrative Guide

Our members have certain rights and responsibilities to help uphold the quality of care and services they receive from you. We list the rights and responsibilities in the member materials for commercial and MA benefit plans.

  • You can request a copy of the Member Rights and Responsibilities by calling your Provider Advocate at 877-842-3210.
  • An online version of member rights is on UHC.com > Featured Links > About Us > Member Rights & Responsibilities. These apply to all members.
  • Member Rights and Responsibilities specifically for MA members can be found on uhcmedicaresolutions.com > Our Plans > Medicare Advantage Plans > Resources and Plan Materials > Plan Information and Forms > Member Rights and Responsibilities.
  • We publish the Member Rights and Responsibilities Statement every year in the Network Bulletin. MA member information is in the March edition. Commercial member information is in the July edition. The monthly bulletins are available on UHCprovider.com/news.

Member’s Request for Confidentiality

The state and federal government allows an individual, other than the subscriber, to request confidential treatment as it relates to:

  • Referrals
  • Authorizations
  • Denials
  • Claims payments

We require our members to submit written requests for confidential status to you. The request must include their current address, private phone number, and date and time you received it. Having a written request prevents disputes regarding the accuracy of their personal contact information. Members are responsible for resubmitting new confidentiality forms if their information changes.

Privacy Regulations

HIPAA Privacy Regulations provide federal protection for the privacy of health care information. These regulations control the internal and external uses of health information. They also create certain individual patient rights. Information related to our privacy practices can be found on uhc.com > Privacy.

Advance Directives

The federal Patient Self-Determination Act (PSDA) gives patients the legal right to make choices about their medical care prior to a severe illness or injury through an advance directive. Under the federal act, care providers and facilities must give patients written information on:

  • State laws about advance treatment directives
  • Patients’ rights to accept or refuse treatment
  • Their own policies regarding advance directives

We also inform members about state laws on advance directives through our member’s benefit material. We encourage these discussions with our members.

Information is also available from the Robert Wood Foundation, Five Wishes. The information there meets the legal requirements for an advance directive in in certain states and may be helpful to members. Five Wishes is available on AgingWithDignity.org.