New Jersey law requires that each patient receiving services in an ambulatory care facility be afforded certain rights. According, please take notice that as a patient of Bergen County Surgery Center, you are entitled to the following rights:
To be informed of these rights. You are entitled to a written copy of these rights as well as written or verbal explanation given, in terms you could understand. The center will notify you of any rules and regulations it has adopted governing patient conduct in the facility;
To be informed of the services offered at the center, the names of the professional staff and their professional status of who is providing and/or responsible for the patient’s care;
To be informed of the fees and related charges, including the payment, fee, deposit, and refund policy of the center and any charges not covered by third-party payers or by the center’s basic rate;
To be informed if the center has authorized other health care and educational institutions to participate in your treatment. You also shall have a right to know the identity and the function of these institutions, and to refuse to allow their participation in your treatment;
To be informed, in terms that you can understand, of your complete medical/health condition or diagnosis, the recommended treatment, treatment options, including the option of no treatment, risks of treatment, and expected results. If this information would be detrimental to your health, or if you are not capable of understanding the information, then the information will be provided to your next of kin or guardian;
To participate in the planning of your care and treatment, and to refuse such care and medication;
To be included in experimental research only when you give informed, written consent to such treatment, or when a guardian gives such consent for you if you are incompetent in accordance with law, rule and regulation. You may refuse to participate in experimental research, including the investigation of new drugs and medical devices;
To voice grievances or recommend changes in policies and services to the center’s personnel, the governing authority and/or outside representatives of your choice, either individually or as a group, and free from restraint, interference, coercion, discrimination, or reprisal;
To be free from mental and physical abuse, free from exploitation, and free from use of restraints unless they are authorized by a physician for a limited period of time to protect you or others from injury. Drugs and other medications shall not be used for discipline of patients or for convenience of facility personnel;
To confidential treatment of information about you. Information in the patient’s medical record shall not be released to anyone outside the facility without your approval, unless another healthcare facility to which you are transferred requires that information, or unless the release of the information is required and permitted by law, a third party payment contract, or a peer review, or unless the information is needed by the New Jersey State Department of Health for statutory authorized purposes. The facility may release data about you for studies containing aggregated statistics when your identity is masked;
To be treated with courtesy, consideration, respect and recognition of your dignity, individuality, and right to privacy, including, but not limited to, auditory and visual privacy. Your privacy shall also be respected when facility personnel are discussing you;
To not be required to perform work for the facility unless the work is part of your treatment and is performed voluntarily by you. Such work shall be in accordance with local, State, and Federal laws and rules;
To exercise civil and religious liberties, including the right to independent personal decisions. No religious beliefs or practices, or any attendance at religious services, shall be imposed upon any patient;
To not be discriminated against because of age, race, religion, sex, nationality, or ability to pay, or deprived of any constitutional, civil, and/or legal rights solely because of receiving services from the facility;
The Administrator will provide upon request to all patients and/or their families, the names, addresses, and telephone numbers of the following offices where complaints may be lodged:
New Jersey Department of Health
for the Institutionalized Elderly
The Administrator shall also provide all patients and/or their families, upon request, the names, addresses and telephone numbers of offices where information concerning Medicare and Medicaid coverage may be obtained. The addresses and telephone numbers will be conspicuously posted throughout the facility, including, but not limited to, the admissions waiting room;
To expect and receive appropriate assessment, management and treatment of pain as an integral component of your care in accordance with N.J.A.C.8:43E-6;
If a patient is adjudged incompetent under applicable State laws by a court of proper jurisdiction, the rights of the patient are exercised by the person appointed under State law to act on the patient’s behalf.
In order to provide you, the patient, with the optimal quality of care, we ask that you comply with the following responsibilities:
You, or your family, will provide information about past illnesses, hospitalization, medication and other matters relating to your health history.
You will cooperate and follow the care prescribed or recommended for you by your physician, nurses, or allied health personnel.
You will notify your physician or nurse if you do not understand your diagnosis, treatment or prognosis.
You will advise your nurse, physician, or the nurse manager of any dissatisfaction you may have regarding your care at the facility.
You will assume financial responsibility for services rendered, either through third party payers (your insurance company) or through self-payment for services not covered by your insurance company.
You will not take drugs which have not been prescribed to you by your attending physician and administered by the staff; and you will not complicate or endanger the healing process by consuming alcoholic beverages or toxic substances during your stay.
You will abide by the facility rules and regulations and be considerate of the rights of other patients and facility personnel.
You will be courteous to the treating staff.
Bergen County Surgery Center is dedicated to providing patients with as much information as possible regarding potential healthcare costs. Please be aware that your procedure may include multiple costs in addition to the facility fee, such as your doctor’s fee, the anesthesia and possible lab fees.
We doo not participate with Medicare or other in-network plans.
It is important that you contact your insurance company prior to receiving services or care. Each plan is different and some provide different levels of coverage that could make a difference in your out of pocket costs. It is always best to contact your insurance company to obtain more information. In addition, the physicians who provide care in our facility, might not participate in the same insurance plans as we do. You should check with the physician who is arranging your healthcare services to see which insurance plans the physician participates in. You should also know that these healthcare professional(s)’ costs are not included in the facility’s charges. They will bill separately.
