To ensure that our enrollees receive high-quality, patient-centered care while protecting their interests and promoting transparency in the health insurance ecosystem, we will promote the rights of our clients by supporting timely access to necessary healthcare services.

In keeping with the regulatory guidelines, our enrollees will also be granted the freedom to choose health care providers within our network, and access to emergency care without prior authorization, subject to a later verification. Stakeholder rights to appeal against denied claims or treatment decisions will be upheld, just as clients’ rights to protection of their personal health records, and clear explanations of coverage, costs, and billings.

Using our quality assurance mechanisms, we will uphold clients’ rights of access to quality and evidence-based care, coverage of preventive and promotive services as well as clear, accurate, and timely information about their coverage. Your right to prompt resolution of grievances, continuity of care during changes in coverage, disability protection and non-discrimination will also be respected by Healthnomics HMO.

Ultimately, your rights to external review of coverage decisions and appeals will be upheld.