What Are My Child’s Rights and Responsibilities

Member Rights and Responsibilities

Member Rights.

1. You have the right to get accurate, easy-to-understand information to help you make good choices about you or your child’s dentists and other providers.
2. You have the right to know how your child’s dentists are paid. You have a right to know about what those payments are, and how they work.
3. You have the right to know how UnitedHealthcare Dental decides about whether a service is covered or medically necessary. You have the right to know about the people in UnitedHealthcare Dental’s office who decide those things.
4. You have the right to know the names of the dentists and other providers enrolled with UnitedHealthcare Dental and their addresses.
5. You have the right to pick from a list of dentists that is large enough so that your child can get the right kind of care when your child needs it.
6. You have the right to take part in all the choices about your child’s dental care.
7. You have the right to speak for your child in all treatment choices.
8. You have the right to get a second opinion from another dentist enrolled with UnitedHealthcare Dental about what kind of treatment your child needs.
9. You have the right to be treated fairly by UnitedHealthcare Dental, dentists, and other providers.
10. You have the right to talk to your child’s dentists and other providers in private, and to have your child’s dental records kept private. You have the right to look over and copy your child’s dental records and to ask for changes to those records.
11. You have a right to know that dentists, hospitals, and others who care for your child can advise you about your child’s health status, medical care, and treatment. Your child’s dental health plan cannot prevent them from giving you this information, even if the care or treatment is not a covered service.
12. You have a right to know that you are not responsible for paying for covered services for your child. Dentists, hospitals, and others cannot require you to pay any other amounts for covered services.
13. You have the right not to be secluded or restrained as a punishment or to make things easier for your provider. 

Member Responsibilities.

You and UnitedHealthcare Dental both have an interest in seeing your child’s dental health improve. You can help by assuming these responsibilities.

1. You and your child must try to follow healthy habits, such as encouraging your child to exercise, to stay away from tobacco, and to eat a healthy diet.
2. You must become involved in the dentist’s decisions about you and your child’s treatments.
3. You must work together with UnitedHealthcare Dental’s dentists and other providers to pick treatments for your child that you have all agreed upon.
4. If you have a disagreement with UnitedHealthcare Dental, you must try first to resolve it using UnitedHealthcare Dental’s complaint process.
5. You must learn about what UnitedHealthcare Dental does and does not cover. You must read your Member Handbook to understand how the rules work.
6. If you make an appointment for your child, you must try to get to the dentist’s office on time. If you cannot keep the appointment, be sure to call and cancel it. 
7. You must report misuse by dental and health care providers, other members, UnitedHealthcare Dental, or other dental or medical plans.

Additional Member Responsibilities while using Nonemergency Medical Transportation (NEMT) Services for Medicaid members.

1. When requesting NEMT Services, you must provide the information requested by the person arranging or verifying your transportation.
2. You must follow all rules and regulations affecting your NEMT services. 
3. You must return unused advanced funds. You must provide proof that you kept your dental appointment prior to receiving future advanced funds.
4. You must not verbally, sexually, or physically abuse or harass anyone while requesting or receiving NEMT services.
5. You must not lose bus tickets or tokens and must return any bus tickets or tokens that you do not use. You must use the bus tickets o tokens only to go to your dental appointment.
6. You must only use NEMT Services to travel to and from your dental appointments.
7. If you have arranged for an NEMT service but something changes, and you no longer need the service, you must contact the person who helped you arrange your transportation as soon as possible.  

If you think you have been treated unfairly or discriminated against, call the U.S. Department of Health and Human Services (HHS) toll-free at 1-800-368-1019. You also can view information concerning the HHS Office of Civil Rights online at www.hhs.gov/ocr