8895 Broadway
Merrillville, IN 46410
219-736-4660 ext. 136

go to map

Patient Rights and Responsibilities

Every patient has the right to be treated as an individual with his/her rights respected. Your patient rights are as follows:

To receive treatment without discrimination as to race, color, religion, sex, national origin, disability, or source of payment.
To receive considerate and respectful care in a clean and safe environment free of unnecessary restraints.
To understand the indications for the procedure.
To receive all the information you need to give informed consent for any procedure, including the possible risks and benefits of the procedure.
To receive complete information your diagnosis, planned treatment and prognosis. When it is medically inadvisable to give such information to you , the information will be provided to a person designated by you or to a legally authorized person.
To participate in all decisions involving health care, except when such participation is contra-indicated for medical reasons.
To receive assessment and management of pain.
To privacy, confidentiality and integrity of all information and records regarding your care.
To approve or refuse the release of your medical records except when required by law.
To be aware of fees for service the billing process.
To refuse treatment and to be told what effect this may have on your health.
To complain without fear of reprisals about the care and service you are receiving.
To be assured sage use of equipment by trained personnel.
To refuse to participate in experimental research.
To change physicians if you choose to do so, or if other qualified physicians are available.

Patient Conduct and Responsibility

To provide the health care providers with information about any past illnesses, hospitalizations, medications and other health matters.
To ask questions if you do not understand instructions or explanations given by the health care providers and/or staff.
To keep appointments as scheduled and to telephone the office in case of cancellation.
To follow health care providers instructions and plan of treatment.
To make payments for services rendered if a balance remains after insurance pays.
To discuss consequences of refusing treatment or not adhering to plan of treatment of leaving "against medical advice" (AMA), with your physician.
To refuse to participate in experimental research.
To refuse to allow care from a student or trainee.

We appreciate you choosing our Endoscopy Center for your procedure. This information should help eliminate some of your billing questions.

You will receive two statements after your visit here – one from Internal Medicine Associates for the physician fee and on from IMA Endoscopy SurgiCenter fr the facility (hospital) fee. In addition, if biopsies are taken during the procedure, you will receive a third statement from the pathology service. (OncoDiagnostics or Methodist Hospital Pathologists)

All charges will be submitted to your insurance company. All of our physicians accept Medicare assignment. If you have any questions, the accounting staff can be reached at 219-738-2724.

You are responsible for any balance remaining after the insurance company has paid.