Member Rights, Responsibilities and Privacy

As one of the largest physician networks in northern California, Hill Physicians Medical Group (Hill Physicians) is dedicated to providing the highest quality patient care. We provide our healthcare services without regard to race, ethnicity, national origin, religion, gender, age, mental or physical disability, sexual orientation, genetic information, or source of payment.

Our Commitment to Your Rights

Hill Physicians is committed to ensuring your rights as a patient, including your right:

To information about your rights and responsibilities, our organization, our services and our practitioners and providers
To participate in all decision making regarding your healthcare and to extend your decision-making rights to parents, guardians, family members or other conservators if you are unable to fully participate in your treatment decisions (advance directives)
To discuss appropriate or medically necessary treatment options regardless of cost or benefit coverage
To voice complaints or appeals about the organization or care provided and to receive information on the grievance procedures for Hill Physicians and your applicable health plan
To be treated with respect and courtesy and with recognition of your dignity and right to privacy

Your Commitment to Your Responsibilities

To ensure the delivery of the best quality of care, Hill Physicians asks our members:

To maintain a good relationship with your primary care physician and communicate when you have questions or concerns about your healthcare.
To provide the information needed by your physician and Hill Physicians in order to provide you with care.
To follow through with the healthcare plans and instructions agreed to with your physicians and other healthcare providers.
To educate yourself about your health plan benefits and services, including exclusions, and how to obtain these benefits and services.

If you have questions or comments about these rights and responsibilities, contact our Customer Service Center by phone, mail, or email.

Affirmation Statement

Utilization Management decision making is based only on appropriateness of care and service and existence of coverage.
The organization does not specifically reward practitioners or other individuals for issuing denials of coverage or care.
Financial incentives for Utilization Management decision makers do not encourage decisions that result in underutilization.

Medical Information Privacy

Hill Physicians is firmly committed to the protection of your personal health information and has adopted stringent policies and procedures to ensure the privacy of this information. Our Notice of Privacy Practices describes how we use, disclose and protect your medical information and lists your rights as a patient to your medical information. Read our Hill Physicians Notice of Privacy Practices.

The Hill Physicians policies and procedures are in full compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the federal regulation established to provide protections for the privacy and security of an individual's health information.

In addition to protecting the privacy of personal medical information, HIPAA gives patients certain rights regarding their individual health information.

Click on the links to download the relevant request forms for these rights.

You will need Adobe Acrobat Reader to view and print these files. You can download a free copy of Adobe Acrobat Reader from the Adobe website.

The right to access your individual health information
The right to request an amendment of your health information if you believe the information is incorrect or incomplete
The right to have an accounting of who has had access to your health information outside the parameters of payment, treatment and operations
The right to request restrictions on who has access to your individual health information
The right to request an alternative method of communication
The right to file a complaint if you believe your privacy rights have been violated

Notice of Privacy Practices and Privacy Rights Request Forms

You will need Adobe Acrobat Reader to view and print these files. You can download a free copy of Adobe Acrobat Reader from the Adobe website.

Hill Physicians Notice of Privacy Practices
Authorization for Release of Medical Information
Request to Amend the Designated Record Set (California Addendum)
Right to an Accounting of Disclosures
Alternative Communication Request
Request to Restrict Use and/or Disclosure of Protected Health Information
Privacy Complaint/Violation Reporting Form

For More Information

For additional information regarding these policies or to receive a printed copy of the Notice of Privacy Practices or any of the request forms, contact our Customer Service Center by phone, mail, or email.

Read about our policies and procedures for Website Privacy.