Patient Rights and Responsibilities

Effective Date: April 10, 2025

I.     Introduction

At Mirror Health Specialists, we are committed to delivering high-quality, respectful, and patient-centered care. Our philosophy is rooted in mutual trust, open communication, and shared responsibility between patients and their healthcare team. This document outlines your rights and responsibilities as a patient and includes important information about how we protect your medical records, your right to advance directives, privacy and nondiscrimination protections, and the appropriate conduct expected of all persons engaging with our practice.

II.   Your Rights as a Patient

As a patient of Mirror Health Specialists, you have the right to:

1. Respectful and Nondiscriminatory Care

  • Be treated with dignity, respect, and compassion in a safe and supportive environment.

  • Receive care without discrimination based on race, color, national origin, ethnicity, ancestry, cultural background, language, religion, age, sex, sexual orientation, gender identity or expression, marital status, disability, health condition, genetic information, source of payment, or immigration status.

2. Information and Informed Decision-Making

  • Receive complete, accurate, and understandable information about your diagnosis, treatment options, risks and benefits, prognosis, and potential outcomes.

  • Be involved in your treatment decisions and give informed consent before any treatment or procedure, unless medically urgent situations prevent it.

  • Refuse any treatment to the extent permitted by law and be informed of the medical consequences of your decision.

3. Advance Directives

  • Be informed of your right to make an Advance Health Care Directive, such as a durable power of attorney for health care or living will.

  • Appoint someone to make healthcare decisions on your behalf if you become unable to do so.

  • Request information or assistance in creating or revising an advance directive during your visit. Your directive will be honored to the extent allowed by law and medical ethics.

4. Confidentiality and Privacy of Health Information

  • Have your Protected Health Information (PHI) kept confidential as required by HIPAA and the California Confidentiality of Medical Information Act (CMIA).

  • Receive our Notice of Privacy Practices (NPP) and be informed of how your information may be used or shared.

  • Request limits on how your information is disclosed and request communications via alternate means or locations.

5. Access to and Correction of Medical Records

  • Inspect and obtain a copy of your medical records, request amendments, and receive a summary or explanation of your health information.

  • Your records are maintained in secure electronic systems with safeguards against unauthorized access. Only authorized staff may access them.

6. Continuity of Care and Second Opinions

  • Receive timely, coordinated, and appropriate care.

  • Request a second opinion from another qualified healthcare professional when appropriate.

7. Voice Complaints or Concerns

  • File a complaint or grievance about your care or privacy without fear of retaliation.

  • Contact our Chief Legal and Compliance Officer or the U.S. Department of Health and Human Services as outlined in our NPP.

8. Communication Assistance

  • Receive communication in a language or format you understand. Interpreter services and auxiliary aids are available at no cost to patients with limited English proficiency or disabilities.

III. Your Responsibilities as a Patient

To help us provide you with effective care, we expect you to:

1. Provide Accurate and Complete Information

  • Inform us of your current and past health conditions, medications, allergies, previous treatments, and any other relevant information.

  • Provide accurate insurance, billing, and contact information.

2. Participate in Your Care

  • Follow the care plan developed with your provider.

  • Ask questions when you do not understand something.

  • Inform us if you are unable to follow a treatment plan or if it is not working for you.

3. Show Respect and Maintain Civility

  • Treat staff, providers, and fellow patients with courtesy, dignity, and respect.

  • Avoid behavior that is disruptive, threatening, discriminatory, or abusive.

  • Understand that threatening or aggressive behavior, including use of slurs, physical violence, or harassment, may result in corrective action up to dismissal from the practice.

4. Keep Appointments

  • Arrive on time and cancel or reschedule in advance when necessary.

5. Financial Responsibility

  • Pay all co-pays, fees, and charges not covered by insurance.

  • Comply with payment policies, including those related to late cancellation, no-show, and membership billing, as outlined in your Financial Responsibility Agreement.

6. Protect Identification

  • Only you are allowed to use your patient account. Using another individual’s identity or allowing someone else to use yours may result in termination of care.

IV. Confidentiality and Storing of Medical Records

  • Your medical information is stored securely using HIPAA-compliant electronic medical records (EMR) systems with encryption, access control, and other safeguards.

  • Only authorized personnel have access to your information on a need-to-know basis.

  • We do not disclose your PHI without your consent unless legally required or permitted under HIPAA/CMIA.

  • You may request a paper or electronic copy of your records at any time. Requests must be submitted in writing to our Chief Legal and Compliance Officer.

V.   Interpretation and Accessibility Services

We provide language interpretation, auxiliary aids, and other accommodations free of charge to ensure access to services for patients with limited English proficiency or disabilities. Let our team know if you need assistance at any point during your care.

VI. Questions or Concerns

If you have questions about your rights and responsibilities, or if you need to submit a complaint or request an accommodation, please contact:

Mirror Health Specialists
Attn: Chief Legal and Compliance Officer
5750 Downey Ave., Ste. 303
Lakewood, CA 90712
Email: joyce.mymirrorhealth@gmail.com
Phone: (657) 708-0074

We are here to support you and ensure a positive, respectful experience in your care journey.

Thank you for trusting Mirror Health Specialists with your health and well-being.