Presbyterian Senior Care (HMO) and Presbyterian MediCare PPO | Fall 2019 | Your Story

www.phs.org/Medicare 9 Listening and responding We’re committed to providing you high-quality care and service. If you’re not happy with our care and service, we want to know. Some problems call for formal attention. In those cases, you have a right to file a grievance, a complaint, or an appeal. • Complaint (also referred to as grievance): If you have a complaint about care or services you receive, you can file a grievance. • Appeal: If we deny a request for service or care and you do not agree, you can file an appeal. If you have a concern, the first thing to do is to contact the Presbyterian Customer Service Center (PCSC). The numbers are listed on your member ID card, in your Member Handbook, and in this newsletter. If the PCSC can’t resolve your concern, you can ask to speak to a Presbyterian Grievance Coordinator. You may also write to the Grievance Coordinator for written details about our procedures or your concerns. You may wonder how to make sure your family knows what your wishes are if you are injured or sick and can’t speak for yourself. An advance directive helps to make your wishes clear so that they are followed. Your advance directive may include: ● ● Choosing a healthcare decision maker. This is the person(s) who will speak about your medical decisions for you if you are injured or sick and cannot speak for yourself. ● ● Information about your healthcare decisions. Your advance directive can include specific orders about what medical support you want or do not want if you become seriously ill. ● ● A do-not-resuscitate order. Sometimes this is called a DNR. A DNR order says that you do not want cardiopulmonary resuscitation (CPR or mouth-to-mouth) to be performed if your heart stops beating or if you stop breathing. You do not need to use a specific form, but Presbyterian has an advance directive form that you may use. You do not need a lawyer to make an advance directive. You also do not need a notary or witness to sign your advance directive in New Mexico. Each state may have different guidelines. If you have an advance directive, give a copy to your provider to add to your medical record. You can find the Presbyterian advance directive form at www.phs.org in the member rights and responsibilities section. 1. Go to www.phs.org . 2. Scroll to the very bottom of the page and select Member Rights . 3. Scroll to bottom to find the advance directive form. You can learn more about advance directives by calling the Presbyterian Customer Service Center at the number on your member ID card. Information is also in your Member Handbook. Advance directives 1 2 3 Presbyterian Grievance Coordinator 9521 San Mateo Blvd. NE Albuquerque, NM 87113