Patient Rights
Patients have the right to be treated without regard to race, ethnicity, national origin, religion, sex, age, mental or physical disability or medical conditions, sexual orientation, claims experience, medical history, evidence of insurability, genetic information, or source of payment.
Receive healthcare services consistent with the benefits covered in their policy based on race, ethnicity, national origin, religion, sex (including gender identity or gender expression), age, mental or physical disability or medical condition, sexual orientation, claims experience, medical history, evidence of insurability (including conditions arising out of acts of domestic violence), disability, genetic information, or source of payment.
Be treated in a manner respectful to your personal privacy and dignity.
Patients shall be free from all forms of abuse and harassment.
Receive assistance in a prompt, courteous, respectful and responsible manner.
Receive care in a safe setting.
Knowledge of the name of the physician who has primary responsibility for coordinating your care.
Be informed by your treating provider of your diagnosis, prognosis and treatment options in terms you understand, and regardless of cost or benefit coverage.
Participate in decisions regarding medical care, be advised by your treating provider of the possible consequences of your decisions and refusing treatment.
Have no restrictions placed on any provider that precluded discussing appropriate treatment options with you. Utilization Management (UM) decisions are based on the appropriateness of care and service required for each patient’s individual needs. We do not receive compensation for the denial of service or care. Requests for coverage of services are reviewed to determine that the service is a covered benefit under the terms of the member’s plan and that the service delivered is consistent with established guidelines. In the event a request for coverage with you insurance is denied, the member, or a provider acting on behalf of the member, may appeal this decision through the grievance process and, depending on the specific circumstances, to an external utilization review organization, which uses independent physician reviewers, a governmental agency or the plan sponsor.
Be advised our clinic does not engage in or perform human experimentation/research. Should this change, the patient would be specifically notified of the proposal and have the right to refuse to participate in research projects.
Be referred, according to your needs, to a provider suitable to care for your condition.
Be assured of confidential handling of all communication and medical information as provided by law and professional medical ethics.
Express concerns including quality of care issues, receiving a response in a timely manner and initiating the grievance procedure through your health plan if you are not satisfied with our resolution of your complaint.
Receive information about the clinic, its services, practitioners and providers, and patients rights and responsibilities.
Patients shall be free to exercise their rights without being subjected to discrimination or fear of reprisal.
** Guardian, patient representative or the person with medical power of attorney for the patient shall be able to exercise these rights on behalf of the patient.
If you ever have a compliment or concern, we encourage you to call or write our Customer Relations department:
Apex Med Family Healthcare
Attn: Customer Relations
99 North San Antonio Ave., Suite 210
Upland, CA 91786
(909) 581-8509
For hearing impaired services – TTY 711
You may also contact or make a formal complaint to:
California Department of Public Health
(888) 354-9203
Department of Managed Health Care at:
980 9th Street, Suite 500
Sacramento, CA 95814
(888) 466-2219
FAX: (916) 255-5241
www.dmhc.ca.gov
Medicare Patients:
Office of the Medicare Beneficiary Ombudsman
1-800-Medicare (1-800-633-4227) (24 hours a day/7 days a week)
www.medicare.gov/navigation/help-and-support/ombudsman.aspx
Discrimination is Against the Law:
Apex Med Family Healthcare complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Apex Med Family Healthcare does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
In compliance with the Americans with Disabilities Act (ADA), qualified interpreters and other auxiliary aids and services are available free of charge to people who are deaf or hard of hearing.
For more information about the Americans with Disabilities Act (ADA), call the Department of Justice’s toll-free, ADA Information Line at 1-800-514-0301 (voice), 1-800-514-0380 (TTY), or visit the ADA Home Page at www.ada.gov
Apex Med Family Healthcare’s ADA Coordinator can be reached at (909) 581-8509.
Apex Med Family Healthcare:
Provides free aids and services to people with disabilities to communicate effectively with us, such as:
Qualified sign language interpreters
Written information in other formats (large print, audio, accessible electronic formats, other formats)
Provides free language services (qualified interpreters, information written in other languages) to those people whose primary language is not English, such as: Spanish, Chinese, Mandarin, Chinese Cantonese, Tagalog, French, Vietnamese, German, Korean, Russian, Arabic, Italian, Portuguese, French Creole, Polish, Hindi, and Japanese
To access language or LEP (Limited English Proficiency) services at no cost to you, call the number on your insurance ID card.
Para acceder a los servicios de idiomas sin costo, llame al número que figura en su tarjeta de identificación. (Spanish)
If you need these services, contact:
Apex Med Family Healthcare Customer Relations Department: 909‐581‐8509
If you believe that Apex Med Family Healthcare has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with:
Apex Med Family Healthcare
Customer Relations Department
99 North San Antonio Ave., Suite 210
Upland, CA 91786
(909) 581-8509
For hearing impaired services – TTY 711. To access language or LEP (Limited English Proficiency) services at no cost to you, call the number on your insurance ID card.
You can file a grievance in person or by phone. If you need help filing a grievance, Apex Med Family Healthcare Customer Relations Department is available to help you. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf or by mail or phone at:
U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201
800‐368‐1019
800‐537‐7697 (TDD/TTY)
Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html