Appendices
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6. Select the medical equipment supplier of your choice.
7. Make informed decisions regarding your care planning.
8. Understand what services will be provided to you.
9. Obtain an explanation of charges, including policy for pay-
ment.
10. Agree to or refuse any part of the plan of service or plan of
care.
11. Voice complaints without fear of termination of service or
other reprisals.
12. Have your communication needs met.
You have the responsibility to:
1. Ask questions about any part of the plan of service or plan of
care that you do not understand.
2. Use the equipment for the purpose for which it was pre-
scribed, following instructions provided for use, handling
care, safety and cleaning.
3. Supply Insulet Corporation with insurance information nec-
essary to obtain payment for services.
4. Be accountable for charges not covered by your insurance.
You are responsible for settlement in full of your account.
5. Notify us immediately of:
a. Equipment failure, damage or need of supplies.
b. Any change in your prescription or physician.
c. Any change or loss in insurance coverage.
d. Any change of address or telephone number, whether
permanent or temporary.
Содержание UST200
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