Rights and Responsibilities

Your Rights

  • Get information about CareSource PASSE, our services, our providers, and member rights and responsibilities.
  • Understand CareSource PASSE and your Person-Centered Service Plan and get services through it.
  • Have information on PASSE services that are offered by CareSource PASSE that include:
    • Covered benefits and how to get them.
    • If any benefits have prior authorization requirements.
  • Take part in decisions about your health care, including the right to say no to treatment.
  • Get information about treatment options and alternatives in a way that you can understand.
  • Know and discuss medically necessary treatment options for your condition(s), no matter the cost or benefit coverage.
  • Create an advance directive (a written record of your wishes for medical care) without fear of being treated unfairly.
  • File any complaint about not following your advance directive with the Arkansas Department of Human Services at 501-682-8292 (TTY/TDD: 711).
  • Make suggestions about CareSource PASSE’s member rights and responsibility policy.
  • Be treated with respect and with regard for your dignity and privacy.
  • Be sure your personal information and medical records are kept private.
  • Be free from any form of restraint or seclusion used as a means of coercion, discipline, convenience or retaliation.
  • Live in an integrated and supported setting in the community and have control over aspects of your life.
  • Be protected in the community.
  • Voice complaints and appeals about CareSource PASSE or the care we provide.
  • Get all written member information from CareSource PASSE:
    • At no cost to you.
    • In your primary language.
    • In other formats, to help with special needs if you have trouble reading the information for any reason.
  • Choose an in-network provider for a service you are eligible and authorized to get under your PCSP, including a PCP.
  • Keep your Medicare PCP if you want to.
  • Women have the right to see a women’s health provider for covered women’s health care.
  • Ask for and get a copy of your medical records. You can also ask for them to be changed or corrected.
  • To be free to carry out your rights and know that CareSource PASSE, CareSource PASSE providers, or the Arkansas Department of Human Services will not hold this against you.
  • Get information on how to file a complaint, grievance, appeal, or ask for a state fair hearing.
  • File a complaint against CareSource PASSE or any of its representatives, including providers.
  • File a grievance, appeal, or ask for a state fair hearing.
  • Get help free of charge from CareSource PASSE and its providers if you do not speak English or need help in understanding information.
  • Get help free of charge with auxiliary aids like TDD/TTY and sign language if you are hearing impaired.
  • Know that CareSource PASSE must follow all federal and state laws, and other laws about privacy that apply.
  • Get all needed, available, and accessible health care services covered under CareSource PASSE and the Medicaid state plan in a timely manner.
  • Get covered services out-of-network if CareSource PASSE is unable to provide a necessary and covered service in-network for as long as it is unable to provide the service in-network. If you are approved to go out-of-network, the services are provided at a cost no greater than it would be in-network.
  • Get a written notice within seven business days if there is a change in your care coordinator.
  • Get a member handbook and provider directory sent or made available to you within five business days of joining CareSource PASSE.
  • Get a second opinion of a medical treatment from a network provider. If a network provider is not available, you can get a second opinion outside the network.
  • Get the following information on CareSource PASSE from Member Services:
    • Structure, governance, and operation.
    • How CareSource PASSE rates on quality metrics and performance measures tracked by DHS or CMS.
    • The PASSE’s non-discrimination policies and the individuals responsible for overseeing those policies, as well as responding to accessibility and discrimination claims made against the PASSE.
    • A list of any counseling or referral services not provided by CareSource PASSE because of moral or religious objections, and how they can obtain information on and how to receive those services through DHS.
  • Not be discriminated against due race, color, religion, gender, gender identity, sexual orientation, age, national origin, veteran’s status, ancestry, medical condition (including physical and mental illness), claims experience, receipt of health care, medical history, genetic information or evidence of insurability or disability. Contact the United States Department of Health and Human Services Office for Civil Rights with any complaint of discrimination.

Your Responsibilities

  • Use the providers in the CareSource PASSE network.
  • Go to all of your planned visits to your providers, be on time, and call 24 hours before the scheduled visit to cancel.
  • Follow the plans and instructions for care you have agreed to with your PCP and other providers.
  • Get to know all of the CareSource PASSE covered services and care. Know the procedures and rules to follow to get the covered services and care.
  • Always carry your ID card. Show it when getting care.
  • Never let others use your ID card.
  • Let CareSource PASSE, the Arkansas Department of Human Services, and your providers know if you have a change in your phone number or address.
  • Let CareSource PASSE, the Arkansas Department of Human Services, and your providers know if you are covered by other health insurance.
  • Contact your PCP after going to an Urgent Care or after getting medical or behavioral health care.
  • Provide the information that CareSource PASSE and your providers need, to the extent possible, in order to provide care.
  • Tell us of suspected Fraud, Waste, Abuse and Overpayment.
  • Understand as much as possible about your health issues and take part in reaching goals agreed to with your care coordinator and providers.
  • Report any concerns of child or adult abuse and/or neglect to CareSource PASSE.

Member Services: 1-833-230-2005 (TDD/TTY: 711) Monday through Friday, 8 a.m. – 5 p.m. CT