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The Financial Obligation Form (Form 17) from Your Health Insurance Provider
Ambulatory treatment in the hospital requires a financial obligation form from your health insurance provider (Form 17.)
However, it is possible to be treated in the outpatient clinic without this form if individual payment is made using either cash or credit card. The tariff, as determined by the Department of Health, is presently 178 shekels for an outpatient clinic appointment with a physician specialist.
Patients’ Rights and Responsibilities
At the Tel Aviv Medical Center, we honor your rights as a patient and as a person.
Your Rights
Respect
You have the right to receive considerate treatment that is respectful to your person, acknowledges your beliefs, values your culture and is in adherence to your religious observance.
Privacy
You have the right to receive treatment that maintains your privacy within the context of prevailing conditions of the place in which you are hospitalized. During your examination, you have the right to request the presence of an additional person as an observer within the context of the prevailing conditions of the place in which you are hospitalized.
Confidentiality
Your medical condition and particulars of your treatment are your private concern. Every member of your treating staff is obligated to maintain professional confidentiality. Particulars about your medical condition will be relayed to another person only with your explicit consent or in accordance with the requirements of the law.
Informed Consent
Your free and willing consent is a necessary precondition to treatment. In order to decide on the treatment being offered, you have the right to receive complete and updated information about your diagnosis, the risks of the treatment and of possible side effects. You may also verbally receive information on alternative treatments, if available, or preventive treatment and their associated risk factors. Before surgery or any invasive procedure, you will be asked to sign a consent form after receiving detailed information. Do not hesitate to ask clarifying questions that may arise in your mind before signing the consent form. You have the right to nullify the consent at any stage of the treatment without affecting the relationship between you and the treating staff.
Medical Information
You have the right to receive, throughout the duration of your hospitalization, complete and detailed information regarding your medical condition, treatment and examinations. The information will be given to you in accordance with the policies of the department. Upon discharge, you have the right to receive a written, detailed summary of your hospitalization. Copies of this documentation will remain in your medical file, as well as copies of your x-rays. Some of the duplicates of this information may require payment, according to policies of the Ministry of Health.
Second Opinion
We honor your right to request a second consultative opinion on any medical condition in addition to the direct department staff caring for you. If you choose to do so, please notify either the director of the department or the senior physician responsible for the department. After notifying the senior staff member, you may refer to any specialist of your choosing in coordination with the director of the department. We must clarify that any communication and payment to an outside physician is your own responsibility, and the hospital is in no way obliged or responsible for the matter. The hospital is not obligated to act upon the second opinion.
Your Responsibilities
Together with your rights, there are also a number of responsibilities for you to adhere to in order that we will be able to give you the best and most professional care possible.
You and your guests are requested to strictly behave in a proper and respectful manner while within the walls of the hospital:
To give all information regarding your health to the treating medical staff.
To treat the medical staff with respect.
To maintain cleanliness.
To maintain quiet and avoid loud or disruptive noise.
To abstain from smoking inside the hospital except within specially designated areas.
To avoid damaging hospital property.
To avoid using cellular telephones while in the hospital department.
To leave the hospital when you have been discharged at the end of treatment.
To avoid bringing non-kosher food into the hospital.
To notify your guests as to the acceptable visiting hours in the department. The presence of visitors in the department after visiting hours disturbs the needed rest of the patients and disrupts the ability of the staff to function effectively. |
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