The Basics

This standard spells out the requirement that your organization clearly communicate to consumers their rights and responsibilities.  Minimum requirements include the right to:

• know about your program's philosophy;
• have personal health information handled in compliance with the law;
• know the identity of the DTM program staff member with whom the consumer is dealing, including the right to talk to a supervisor;
• receive current information about program;
• receive information about significant program changes;
• decline participation at any point along the way.

In addition, the consumer must be advised of his/her responsibility to:

• submit appropriate forms required for program participation;
• provide accurate information;
• notify their treating physician of their participation in the DTM program.

This standard requires that all of this information be provided in some form to the consumer shortly after his/her enrollment.

Management Tips

In addition to the appropriate policy and procedural program description, you'll need to make sure that you have complete templates, scripts, letters, or Web content that provide all of this information regarding consumer rights and responsibilities.  As important is that you document how and when your staff provides this information to each consumer who participates in your program.

URAC Accreditation Tips

Nearly all of the elements of the standard are weighted 4, with the exception of the element regarding personal health information, which is mandatory.

Your desktop review submission should include sample templates, scripts, and other communications of rights and responsibilities.  In addition, he should submit sample documentation of how you document that your staff members have provided this information to consumers.

During the on-site review, the reviewer will examine randomly selected consumer records to make sure that each consumer has received his/her notification of rights and responsibilities.  In addition, if consent is applicable, the reviewer will be looking for documentation of that consent.