Below you'll find information on Member's Rights and Member's Responsibilities.
You have the right to:
Be treated with respect, dignity, and the right to privacy.
Make recommendations about the WithMe Health Member Rights and Responsibilities.
Ensure your records are kept confidential to the degree protected by federal and state laws including HIPAA regulations. This includes ensuring personal health information is shared with the DTM program only in accordance with state and federal law.
Receive information about WithMe Health PBM services and benefits, including limitations and exclusions to the formulary, retail and specialty pharmacy network.
Access WithMe Health Guide Team members who can help you resolve problems.
Identify the staff member of the program and their job title, and to speak with a supervisor of the staff member if requested.
Access translation services when contacting WithMe Health if you have language barriers.
Receive covered benefits and prior-authorization reviews within specified timeframes by certified pharmacists who can effectively communicate medication treatment plans.
Voice complaints regarding WithMe Health, its prior-authorization services, appeals processes, or denials, and you have the right to an investigation or second level of review.
Access WithMe Health services, regardless of sex, age, sexual orientation, ethnicity, national origin, religion, genetic information, disability, or payment source.
Know about the philosophy and characteristics of the Drug Therapy Management (DTM) program.
Receive current information from the DTM program, including administrative information regarding changes in or termination of the DTM program.
Decline participation, remove consent or disenroll from the DTM program at any point in time.
It is your responsibility to:
Treat WithMe Health staff with the respect and courtesy that you would expect for yourself.
Read all materials received from your health plan and WithMe Health in order to ensure you are familiar with your benefits, including your drug list and the participating pharmacies in the your network.
Report unethical practices from our provider network as well as any fraud, waste or abuse practices.
Present your member identification card when accessing services.
Learn about your drug therapy options, including the limitations and risks.
Submit any forms that are necessary to participate in the DTM program to the extent required by law.
Give accurate clinical and contact information and to notify the DTM program of changes in this information.
Notify your treating providers of your participation in the DTM program, if applicable.
If You have any questions about these Rights and Responsibilities or otherwise need to contact Us for any reason, You can reach Us at:
WithMe Health, LLC Attn: Legal Department 400 South El Camino Real Suite 1150 San Mateo, CA 94402 Phone: 650.399.0404 Email: email@example.com