Independent Assistance For Health Care Consumers
Program Description
The Health Rights Hotline is an independent program that provides free information and assistance to health care consumers in El Dorado, Placer, Sacramento and Yolo counties. The Health Rights Hotline assists consumers no matter what type of health plan they have - Health Maintenance Organization (HMO), Preferred Provider Organization (PPO) or other plan - and regardless of how they get coverage - whether through an employer, individual coverage, Medicare, Medi-Cal, Healthy Families, or other sources.
Funded primarily by private foundations, the Hotline employs experienced counselors who answer general questions about consumers' rights in health care and help consumers resolve specific health care problems. Since its inception in July 1997, the Hotline has helped more than 20,000 consumers. The Hotline provides the following services:
| Counseling and Referrals | Health Rights Hotline counselors advise consumers about their rights, answer questions consumers have about their health care coverage, and provide general education about navigating the health care system. Counselors educate consumers about how to communicate with health plans and medical groups, how to take charge of their health care, and what steps consumers can take to resolve particular problems. Callers frequently are given referrals to resources that can best help them, such as customer service departments of health plans and provider groups, and other community organizations. | |
| Direct Assistance | When callers have been unable to get their questions answered or their problems resolved after working with their health plan or medical group, a Health Rights Hotline counselor may intervene and advocate on behalf of the caller with the health plan, the provider, a regulatory agency, or other group to seek resolution of the issue(s). | |
| Consumer Education | The Health Rights Hotline provides educational action guides and fact sheets to reinforce how consumers can be their own best advocates, including Choosing a Health Plan or Medical Group, Understanding Your Health Plan Agreement, Referrals and Approvals for Medical Services, What To Do When You Have A Problem With Your Health Plan and How to Appeal a Health Plan or Medical Group Decision. | |
| www.hrh.org | The Hotline's web site contains all of the Hotline's educational materials as well as sample letters consumers can use to appeal a health plan or medical group decision, request a copy of their medical records, or file a complaint with a government agency. | |
| Systemic Advocacy | In addition to assisting individual consumers, the Health Rights Hotline works to improve the health care system in the four county Sacramento area. The Hotline collects and analyzes information on the types of issues consumers face, and provides feedback to health plans, health care providers, purchasers, regulators, and the public regarding consumers' experiences. The Hotline produces reports that analyze Sacramento-area consumers' problems in detail and collaborates with the Health Consumer Alliance, a network of consumer assistance programs in seven other California counties, to assess consumer issues statewide. All of the Hotline's reports are available on its web site. | |
| Independent Evaluations | Through client satisfaction surveys and interviews with health plans, provider groups, consumer organizations and regulatory agencies, two independent evaluations have found that the Health Rights Hotline is effective at helping consumers resolve problems and that it has had a positive impact on the health care system. The evaluations are available on the Hotline's web site. |
For more information, please contact:
the Health Rights Hotline
(916) 551-2100