The patient has specific rights and responsibilities regarding their relationship with a DMEPOS provider.  A copy of these rights and responsibilites will be provided to you during initial setup.

The patient has the right to:

  1. Considerate and respectful service

  2. Obtain service without regard to race, creed, national origin, sex, age, disability or illness, or religious affiliation

  3. Confidentiality of all information pertaining toyou, yourmedicacl care and service

  4. A timely response to your request for service and to expect continuity of services

  5. Select the home medical equipment supplier of your choice

  6. Make informed decisions regarding your care planning

  7. Be told what service will be provided in your home, how often and by whom

  8. An explanation of charges including policy for paymnet

  9. Agree to or refuse any part of the plan of service or plan of care

  10. Voice grievances without fear of termination of service or other reprisals

  11. Have your communication needs met

The patient has the responsibility to:

  1. Ask questions about any part of the plan of service or plan of care that you do not understand

  2. Protect the equipment from fire, water, theft or other damage while it is in your possession

  3. Use the equipment for the purpose for which it was prescribed, following instructions provided for use, handling care, safety and cleaning

  4. Supply us with needed insurance information necessary to obtain payment for services and assume responsibility for charges not covered.  You are responsible for settlement in full of your account.

  5. Be at home for scheduled service visits or notify us in advance to make other arrangements

  6. Notify us immediately of equipment failure, damage or need of supplies, any change in your prescription or physician, any change or loss in insurance coverage, any change of address or telephone number, whether permanent or temporary, or discontinued use equipment or services

  7. Be respectful of the property owned by our company and considerate of our personnel

  8. Contact us if you acquire an infectious disease during the time we provide the services/equipment to you.

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Affordable Medical Supplies

501 W Kinghighway

Paragould, AR 72450

P: (870)-239-0997

F: (870)-239-9037

4707 E Johnson Ave

Jonesboro, AR 72401

P: (870)-972-5900

F: (870) 203-0518

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