Patient Rights & Responsibilities

We are glad that you have chosen to receive your healthcare at Tri-State Community Health Center. We view your healthcare treatment as a partnership between the patient, provider and staff. Because we value your business, we have developed the following guidelines to help avoid misunderstandings and to ensure that we meet your healthcare needs to the best of our ability.

Each patient treated at Tri-State Community Health Center has the right:

  • To know their rights and responsibilities.
  • To be treated with respect with no regard to race, age, color, religion, sex, national origin, handicap, disability or for source of payment.
  • To participate in the development and implementation of your healthcare plan.
  • To speak up if you have questions. It’s okay to ask questions and expect answers in layman’s terms that you can understand. Talk with your provider about options – it is important for you to understand your choices.
  • To have pain managed (if applicable). Tri-State Community Health Center’s approach to pain management will be followed unless the provider feels that an exception is to be made.
  • To have medical records treated confidentially and the right to review your own medical records following the procedures set by Tri-State.
  • To receive information regarding fees for services, payment policies and discounts for services, if under 200% of poverty which is based on income and family size.
  • To receive information regarding advance directives.
  • To have access to an interpreter, whether for hearing impairment or language.
  • To good quality care and high professional standards that are continually maintained and reviewed.
  • To receive information regarding methods of expressing suggestions and grievances.
  • To fill out a patient feedback form, which is available to you from any staff member. These are reviewed daily by the management staff. Patient satisfaction surveys or patient comment cards are available at the checkout desk. You may also ask to speak to the Director of the Center.
  • To prompt notification of test results. Tri-State will notify you by phone if test results are abnormal and by letter if labs are within normal limits. Please keep in mind that when a test is performed at the hospital or another facility, we have to wait until the facility notifies us of the results before we can contact you.
  • To have a contact with an available provider after hours during the week and on the weekends. Limit these calls to serious medical issues that cannot wait until normal office hours.

Each patient treated at Tri-State Community Health Center has the responsibility:

  • To actively participate in their care by providing the staff with an accurate medical history and a list of the medications that they are currently taking. It is the responsibility of the patient to keep the staff informed of any changes.
  • To follow instructions that are given by the provider.
  • To take medications as prescribed. If taking a controlled substance, patient will sign and follow the Controlled Substance Agreement.
  • If pain is an issue – know the Tri-State Community Health Center Approach to Pain Management (unless exception is made by the provider).
  • To keep appointments. If unable to do so, give at least a 24-hour notice.
  • To provide Tri-State Community Health Center with accurate insurance and financial information.
  • To fulfill financial responsibility for all services rendered as determine by patient’s insurance and ability to pay.
  • To inform Tri-State Community Health Center of any complaint or concern by using the above-mentioned ways or by writing to the Center.

Updated 7 July 2014

Administration & Billing Office

109 Rayloc Dr Hancock, MD
Phone: 301-678-5187
Fax: 301-678-5797

Hours: Monday – Friday 8:00 am - 5:00 pm



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