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Sonder Member Rights

Your Rights & Responsibilities

Summary of Rights

Georgia law requires that your health care provider or health care facility recognize your rights while you are receiving medical care and that you respect the health care provider’s or health care facility’s right to expect certain behavior on the part of patients. You may request a copy of the full text of this law from your health care provider or health care facility.

A patient has the right to:

  • Be treated with courtesy and respect, with appreciation of his or her dignity, and with protection of privacy.
  • Receive a prompt and reasonable response to questions and requests.
  • Know who is providing medical services and who is responsible for his or her care.
  • Know what patient support services are available, including if an interpreter is available if the patient does not speak English.
  • Know what rules and regulations apply to his or her conduct.
  • Be given by the health care provider information such as diagnosis, planned course of treatment, alternatives, risks, and prognosis.
  • Refuse any treatment, except as otherwise provided by law.
  • Be given full information and necessary counseling on the availability of known financial resources for care.
  • Know whether the health care provider or facility accepts the Medicare assignment rate if the patient is covered by Medicare.
  • Receive prior to treatment, a reasonable estimate of charges for medical care.
  • Receive a copy of an understandable itemized bill and, if requested, to have the charges explained.
  • Receive medical treatment or accommodations, regardless of race, national origin, religion, handicap, or source of payment.
  • Receive treatment for any emergency medical condition that will deteriorate from failure to provide treatment.
  • Know if medical treatment is for purposes of experimental research and to give his or her consent or refusal to participate in such research.
  • Express complaints regarding any violation of his or her rights.

Summary of Responsibilities

A patient is responsible for:

  • Giving the health care provider accurate information about present complaints, past illnesses, hospitalizations, medications, and any other information about his or her health.
  • Reporting unexpected changes in his or her condition to the health care provider.
  • Reporting to the health care provider whether he or she understands a planned course of action and what is expected of him/her.
  • Following the treatment plan recommended by the health care provider.
  • Keeping appointments and, when unable to do so, notifying the health care provider or facility.
  • His/her actions if treatment is refused or if the patient does not follow the health care provider’s instructions.
  • Making sure financial responsibilities are carried out.
  • Following health care facility conduct rules and regulations.

The patient has the right to file a grievance with the Georgia Composite Medical Board, concerning the physician, staff, office, and treatment received. The patient should send a written complaint to the board. The patient should be able to provide the physician or practice name, the address and the specific nature of the complaint.

Complaints or grievances may be reported to the Board at the following address or telephone number:

Georgia Composite Medical Board
Attn. Complaints Unit
No. 2 Peachtree Street, N.W. 36th Floor
Atlanta, GA 30303
(404) 656-3913
www.medicalboard.georgia.gov

Discrimination Is Against the Law

Sonder Health Plans, Inc., complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Sonder Health Plans, Inc., does not exclude individuals or treat them differently because of race, color, national origin, age, disability, or sex. Sonder Health Plans, Inc. provides: (1) free aids and services to people with disabilities to communicate effectively with us, such as, qualified sign language interpreters and written information in other formats (large print, audio, accessible electronic formats, other formats); and, (2) free language services to individuals whose primary language is not English, such as, qualified interpreters and information written in other languages.

If you need these services, contact the number on the back of your ID Card. If you believe that Sonder Health Plans, Inc, has failed to provide these services or discriminated in any way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Sonder Health Plans, Inc., Attention: Member Services Department, 6190 Powers Ferry Road, Suite 320, Atlanta, GA 30339 or call (888) 428-4440 TTY: 711; Monday through Friday; 8AM to 8PM EST.

You can file a grievance in person, by mail, or by fax. If you need help filing a grievance, our Member Services Representatives are available to help you at the number listed above. You can also file a civil rights complaint electronically through the U.S. Department of Health and Human Services, Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services, 200 Independence Avenue, SW, Room 509F, HHH Building, Washington, D.C. 20201 or call (800) 368-1019, (800) 537-7697 (TDD). Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.

Declaration of Disaster or Emergency

If you’re affected by a disaster or emergency declaration by the President or a Governor, or an announcement of a public health emergency by the Secretary of Health and Human Services, there is additional support available to you. Sonder Health Plans will:

  • Allow plan benefits to be furnished at non-contracted facilities or providers at in-network cost sharing
  • Waive referral requirements, where applicable
  • Waive the 30-day notification requirement to enrollees if a change (such as reduction of cost-sharing and waiving authorization) benefit you
  • Allow you to fill medications sooner than usual to ensure you have what you need during the emergency
  • Allow maximum extended day supplies of drugs
  • Allow filling of prescriptions at non-contracted pharmacies

The end date of the disaster or emergency will be determined by the government entity making the declaration.

Pharmacist assists senior woman with prescriptions.
Download Your Bill of Rights

Utilization Managment Statement

Sonder Health Plan’s utilization management activities are designed so that they do not provide incentives, financial or otherwise, for the denial, limitation, or discontinuation of covered services by Plan staff or network providers.

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