Become Your Own Patient Advocate

Home / Campus / ( Published on 2014-05-04 )

Resources for selecting a health plan, provider, getting the most from your plan and what you can do when things go wrong

Do you have health plan questions or problems?

  • Call your health plan. A customer service representative at your health plan can explain the plan’s policies and procedures. Many problems can be resolved if you work with your health plan member services.  Look on the back of your health plan ID card for the member services phone number.
  • Contact your provider’s office. Your most important relationship is the one you have with your provider or other health professionals.
  • If you are in an HMO, contact your medical group. Most medical groups have patient assistance departments that can help you find a doctor, and work out billing or authorization problems.

Become your own patient advocate!

Take the initiative to manage your health care before you need to access care and/or are in a crisis situation.

  • Selecting a provider that is best suited for you and your family is a foundation for good health care. Good communication and a professional relationship with your provider goes a long way to ensuring your good health. Tips for selecting a provider
  • Review the Evidence of Coverage (EOC) booklet for your plan: This is where you will find detailed information about what is covered and what is not covered under the plan. Be sure to also call your plan before receiving a service to ensure you have coverage.
  • You can appeal a decision rendered by your health plan: Most plans provide information in the EOC booklet on the appeal process.
  • Stay updated on the latest information regarding your UC-sponsored health plans by visiting UCnet regularly.

Medical Plan Comparison
Understanding the general features of each type of medical plan

Balance Billing
Understanding the additional costs associated with using a non-network provider (applies to non-HMO plans)

Consumer Guide to Handling Disputes with Your Health Plan
A general guide to navigating your health plan’s internal grievance procedures and the state’s external review programs.