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You Are a Valued Member

Your “rights” are the things you can count on getting from us. Your “responsibilities” are the things we need from you. As a person with IHN-CCO coverage, you have many rights and responsibilities.

As a member of InterCommunity Health Network CCO (IHN-CCO) and Oregon Health Plan (OHP), you have many rights. These include choosing your own provider and making a complaint to us. Here is a full list of what you can count on from IHN-CCO:

Nondiscrimination

  • Be treated with dignity and respect.
  • Be treated by your doctors the same as they treat all their patients.
  • Get handbooks and letters that you can understand.
  • Get services and support that fit your culture and language needs.
  • Have the same access to care as all members, no matter your age or sex.
  • Complain or appeal and get a response from us without a bad reaction from your plan or provider.
  • Be free from getting restrained or confined unless allowable or needed.
  • Get a copy of our nondiscrimination policy.

Access

  • Choose an in-network PCP when you first enroll and change your PCP at other times.
  • Get mental health and family planning services without a referral.
  • Ask for services as close to home as possible, and in a non-traditional setting that is easier for you to use.
  • Get a sexual abuse exam, if needed, without prior approval.
  • Get care when you need it, any time of day or night (including weekends and holidays) with no prior approval required.
  • See a specialist without a referral.

Care

  • Actively help develop your treatment plan or have family involved in your treatment plan.
  • Get information about OHP-covered and non-covered treatment options for your condition.
  • Agree to or refuse treatment  (except for court-ordered services) and be told how that will affect you.
  • Get the tests you need to find out what condition you have.
  • Get coordinated care and services that are specific to your needs and are medically needed.
  • Have steady and stable contact with a care team that is in charge of your complete care management.
  • Get covered services that help you stay healthy.
  • Have a medical chart kept up to date by your doctor.
  • See and get a copy of your medical chart, unless there is a legal reason that does not allow it. You may ask to change or correct what is in your chart.
  • Have your medical chart sent to another doctor.
  • Have an Advance Directive or Power of Attorney and have your doctors follow it.
  • Get a letter if you are denied a service or there is a change in service. You may not get a letter if the law does not require it.
  • Be told ahead of time if your appointment is not going to happen.
  • Get covered services without owing copays.
  • Get a second opinion at no cost. We can help you find a second doctor to see.
  • Get your doctor’s opinion on treatment available to you.

Support

  • Have a friend, family member, or helper come to your appointments.
  • Have a helper that will coordinate your care in the best location for you.
  • Ask us how to connect to people who can support your overall health and wellbeing.
  • Ask for a hearing with the state if you do not agree with our appeal answer.
  • Ask for an interpreter approved by the state.

Being an IHN-CCO member also means you have responsibilities to us. To help us serve you best, you agree to the following:

  • Find a doctor or other provider you can work with and tell them  about your health.
  • Treat providers and their staff with the same respect you want.
  • Be on time for appointments.
  • Call your provider at least one day before your appointment, if you cannot make it.
  • Have yearly check-ups, wellness visits and other services to prevent illness and keep you healthy.
  • Go to your PCP for all your healthcare needs, unless it is an emergency.
  • Contact your doctor before going to urgent care or the emergency room, unless your condition is life threatening.
  • Be honest with your doctor so your medical record is correct.
  • Help your doctor get medical records from other doctors. You may need to sign a paper to give approval.
  • Ask questions when you do not understand.
  • Use your medical care team resources to make informed choices about your care.
  • Help your doctor create a care plan.
  • Follow the treatment plan you agreed to with your medical care team.
  • Tell your provider you have IHN-CCO and show them your ID card if they ask for it.
  • Call OHP Client Services at 800-699-9075 when you or a family member move in or out of your house or you change your phone number. Also, tell them when you become pregnant, are no longer pregnant, or have a baby.
  • Call OHP Client Services at 800-699-9075 to report any other health insurance. You can also report other health insurance at www.ReportTPL.org.
  • Pay for services you agree to get that are not covered by IHN-CCO.
  • Provide IHN-CCO facts about other sources who are paying for your care. Pay back IHN-CCO for any bills we paid if you get a medical settlement.
  • Tell IHN-CCO if you have a complaint or grievance.

View Your Member Handbook

The information on this page is a summary of your IHN-CCO benefits. For a full description of the benefits and services available to you, read your IHN-CCO 2020 Member Handbook