Your rights while receiving care at our facility

Patient's Bill of Rights and Responsibilities

Dallas Endoscopy Center, LTD recognizes your rights while you are receiving medical care at the facility. Please ask to speak to the Administrator if you have any concerns or complaints. You may request a copy of the full text of the laws pertaining to patient rights and grievance procedures from the administration.

• A patient has the right to be treated with courtesy and respect, with appreciation of his or her individual dignity, and with protection of his or her need for privacy.
• A patient has the right to a prompt and reasonable response to questions and requests.
• A patient has the right to know who is providing medical services, to view their credentials, to know who is responsible for his or her care, and to change providers if dissatisfied with the care received.
• A patient has the right to know what patient support services are available, including whether an interpreter is available if he or she does not speak English.
• A patient has the right to know what rules and regulations apply to his or her conduct.
• A patient has the right to be given by the health care provider information concerning diagnosis, planned course of treatment, alternatives, risks, and prognosis.
• A patient has the right to appropriate assessment and management of pain.
• A patient has the right to refuse any treatment, except as otherwise provided by law.
• A patient has the right to be given, upon request, full information and necessary counseling on the availability of known financial resources for his or her care.
• A patient has the right to receive, upon request, prior to treatment, a reasonable estimate of charges for medical care.
• A patient has the right to receive a copy of a reasonably clear and understandable itemized bill and, upon request, to have the charges explained.
• A patient has the right to impartial access to medical treatment or accommodations, regardless of race, national origin, religion, handicap, or source of payment.
• A patient who is eligible for Medicare has the right to know, upon request and in advance of treatment, whether the health care provider or health care facility accepts the Medicare assignment rate.
• A patient has the right to treatment for any emergency medical condition that will deteriorate from failure to provide treatment.
• A patient has the right to know if medical treatment is for purposes of experimental research and to give his or her consent or refusal to participate in such experimental research.
• A patient has the right to express grievances regarding any violation of his or her rights, as stated in law, through the grievance procedure of the health care provider or health care facility which served him or her and to the appropriate state licensing agency.
• A patient has the right to receive a notice of all protected health information practices.
• A patient has the right to view all protected health information pertaining to him or her.
• A patient has the right to access an accounting of all disclosures.
• A patient has the right to request amendments and corrections to personal information they feel is incorrect.
• A patient has the right to receive confidential communications.
• A patient has the right to complain to the covered entity and the Department of Health and Human Services:
  Texas Unified Licensure Information Portal
  Health and Human Services Commission Complaint and Incident Intake Mail Code E-249
  P.O. Box 149030 Austin TX 78714-9030 Complaint Hotline 1-800-458-9858 Email: hfc.complaints@hhs.texas.gov
• A patient has the right to complain to the Office of the Medicare Beneficiary Ombudsman at:
  1-800-633-4227 TTY 1-877-486-2048

Patient responsibilities

• A patient is responsible for providing to the health care provider, to the best of his or her knowledge, accurate and complete information about present complaints, past illnesses, hospitalizations, medications, and other matters relating to his or her health.
• A patient is responsible for reporting unexpected changes in his or her condition to the health care provider.
• A patient is responsible for reporting to the health care provider whether he or she comprehends a contemplated course of action and what is expected of him or her.
• A patient is responsible for following the treatment plan recommended by the health care provider.
• A patient is responsible for keeping appointments and, when he or she is unable to do so for any reason, for notifying the health care provider or health care facility.
• A patient is responsible for his or her actions if he or she refuses treatment or does not follow the health care provider's instructions.
• A patient is responsible for assuring that the financial obligations of his or her health care are fulfilled as promptly as possible.
• A patient is responsible for following health care facility rules and regulations affecting patient care and conduct.

Complaints & grievances

You have the right to complain, and we will not retaliate against you for filing a complaint. To file a complaint or grievance with the center, or to ask any question about your rights:

• In person: ask to speak to the Administrator at the center.
• By phone: 214.520.8235
• By fax: 214.520.8236
• By mail: Dallas Endoscopy Center, LTD, 3930 Crutcher St, Dallas, TX 75246

You also have the right to complain to the covered entity and the Department of Health and Human Services:

Nondiscrimination notice

Dallas Endoscopy Center complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Dallas Endoscopy Center does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

Dallas Endoscopy Center provides 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). We provide free language services to people whose primary language is not English, such as qualified interpreters and information written in other languages.

If you need these services, or believe that Dallas Endoscopy Center has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with:

You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal. You may email OCR at OCRMail@hhs.gov or call the U.S. Department of Health and Human Services, Office for Civil Rights toll-free at: 1-800-368-1019, TDD: 1-800-537-7697. Complaint forms are available at hhs.gov/ocr.

Texas Advance Directives

Advance directives let you record your wishes for future medical care. Download the Texas forms and instructions in English or Spanish:

• Texas Advance Directives (English PDF)
• Instrucciones anticipadas para Texas (Español, PDF)

Notice of physician ownership

Dallas Endoscopy Center, LTD is privately owned and managed by physicians who practice at the facility. The physicians who practice in this facility are Board approved and licensed in the State of Texas. You may request a review of credentials from our Administrator.

The following physicians hold an ownership or financial interest in the center:

• Dr. Abrar Ahmed
• Dr. Andrea Betesh
• Dr. Esmail M. Elwazir
• Dr. W. Gregory Hodges
• Dr. Rajeev Jain
• Dr. Ben Kahn
• Dr. Jason Martin
• Dr. Michael J. Nunez
• Dr. Kimberly M. Persley
• Dr. Christopher J. Vesy

Physicians who provide care at the center without an ownership interest are identified as providers on our Physicians page.