From an expert here's a primer on preparation and strategy to help make the
grievance and appeal process go smoothly and quickly.
Click on 'General Public' to find advice on choosing health plans as well as
other kinds of health services such as ambulatory care, home care, hospitals,
long-term care, substance abuse help, mental health serices, and
child/adolescent services. There's also a place on this site for registering
complaints against accredited healthcare providers.
The American Association of Health Plans offers easy-to-understand guidance on
what to look for in an HMO and questions to ask about physicians, coverage of
chronic conditions, costs, your own health status, services, etc. This
organization for the HMO industry also offers in their "Research &
Library" studies and articles about the benefits of managed care (such as its
encouragement of preventive medicine) and how quality of care has improved
treatment in certain disease categories (compared to fee-for-service).
Even if you're not a California resident this is another useful, common sense
guide on choosing a HMO health plan.
From the American Association of Retired Persons
Another good resource. Offers 'Ten Important Features to Consider in
Considering an HMO" plus checklists to compare managed care plans, AARP's
views on consumer protections needed for HMOs,
information on managed care vs. traditional insurance, etc.
by the American Hospital Association and the Picker Institute
A report on the state of patient satisfaction in1996 with health care plans,
hospitals, clinics, and doctors. The goal was to evaluate what is and isn't
working for patients, why, and how things can be improved.