PATIENT RIGHTS
You have the right...

1. To have Ravine Way Surgery Center respond to your requests and needs for treatment or service provided that the space is available, and to receive the care that reflects your interests and that has been determined by your physician, and respects your advance directives or your rights to formulate advance directives.

2. To be informed of the right to respectful care that recognizes dignity and is private to the extent possible.

3. To have patient information treated confidentially, based on applicable laws and regulations.

4. To be involved in making decisions regarding your care, including assessment and management of pain.

5. To be given information in the language you understand or to have information interpreted.

6. To give informed consent, that is, to make decisions in collaboration with your physician that involve your health care. Consent may be given by the patient or the patient’s legal representative. In order to give consent, the patient will be provided information to include:

   1. An explanation of recommended treatments or procedures in terms that are understandable.

   2. An explanation of the risks and benefits of treatment, including the chance of success, mortality risk and serious side-effects.

   3. An explanation of the alternatives and the risks and benefits of such.

   4. An explanation of the likely consequences if no treatment is pursued.

   5. An explanation of the recuperative period, including anticipated problems and anticipated length of recuperation.

   6. An explanation that the patient or his/her legal representative is free to withdraw consent and discontinue participation in treatment.

   7. A disclosure statement that the patient’s physician is participating in teaching, research, experimental or education projects relating to the patient’s case.

7. To an explanation of admission procedures, which shall include disclosure upon admission of the facility’s policy statement on patient rights, which shall consist of:

   1. The right to participate in all decisions involving care or treatment, consistent with state and federal statutes.

   2. The right to refuse any drug, test, treatment, procedure or treatment consistent with the state and federal statutes, including likely medical consequences of such refusal.

   3. The right to receive considerate and respectful care in a clean and safe environment, free of unnecessary restraint.

   4. The right to be informed of the facility’s rules and regulations applicable to the patient.

   5. The right to be informed of the facility’s grievance procedure. The Administrator  may be reached by calling (847) 832-3989

   6. The right to file a grievance with the appropriate state agency.*

8. To know name, professional status, and experience of the staff providing care or treatment.

9. To be informed prior to the initiation of general billing procedures:

   1. Prior to the initiation of non-emergency treatment, upon request, the patient has the right to be informed of routine, usual and customary charges or estimated charges for service based on an average patient with a diagnosis similar to the tentative admission diagnosis of the patient.

   2. If you have questions, please call (847) 832-1555  for medical cost information between the hours of 8:00 a.m. and 4:30 p.m. on weekdays.

   3. Based upon insurance information provided by the patient, the facility shall provide assistance as needed with estimates of co-payments, deductibles, or other charges that the patient must pay. Such assistance may be obtained on weekdays between 8:00 a.m. and 4:30 p.m. by calling the facility business office manager.

   4. The facility may include a disclaimer with the disclosure of any charges. Such disclaimer may include further variables, which may alter any disclosed charge. Any charges prohibited by law or third party payor contract will include a no charge disclaimer in the disclosure.

10. To be provided with information regarding teaching, research, educational or experimental projects related to your care. You have the right to refuse to participate in such projects.

11. To have your medical records maintained in confidence and in accordance with the medical staff bylaws, rules and regulations. You have the right to have access to your medical record by contacting the facility at ( 847) 832-1555.

Patient Responsibilities
You have the responsibility...

1. To provide the facility with accurate and complete information about your present complaints and your past health history.
2. To be considerate of other patients, physicians, and facility personnel. To show respect for the belongings of others and facility property.
3. To discuss your health problems with only those involved in your care.
4. To request your records through the facility.
5. To inquire as to the name and purpose of any personnel caring for you.
6. To say whether or not you understand a contemplated course of treatment and your obligations in the administration of the treatment.
7. To cooperate with any research or experimental project in which you consent to participate.
8. To inform the staff that translation is required.
9. To provide the facility with the necessary information for insurance processing and to be prompt in payment of facility bills.
10. To be cooperative during recommended treatment.

If you have any questions regarding your rights or responsibilities please discuss your concerns with us by calling 847-832-1555 or contacting us at 2350 Ravine Way, Suite 500. Glenview, IL 60025

You can view our nondiscrimination policy here.