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Delay in Reports From Office in Charge of Medi-Cal Complaints

Brooke Phillips, CWCMS
Editor | Shield HealthCare
09/04/14  10:21 PM PST
Medi-Cal Complaints

The California Department of Health Care Services unit in charge of handling Medi-Cal beneficiaries’ problems or complaints has not released a quarterly report in nearly 12 months, HealthyCal reports.

Medi-Cal is California’s Medicaid program (Guzik, HealthyCal, 8/26).

Background

DHCS’ Managed Care Ombudsman Office is in charge of responding to Medi-Cal concerns.

In the first six months of this year, the Ombudsman Office received an average of 21,689 calls and emails per month, compared with 14,381 calls and emails per month in 2013 — a 51% increase.

DHCS spokesperson Norman Williams said that a review this month found that calls and emails to the office included:

  • Complaints, accounting for 4% of calls;
  • Requests for expedited enrollment or unenrollment, accounting for 60% of calls; and
  • Questions about other issues, such as eligibility and continuity of care.

Williams said that “a high volume of contacts to the Ombudsman” since the expansion of Medi-Cal have been “related to health care plan issues, including how to access services or who to contact at the plan level with specific questions” (California Healthline, 8/8).

Read Full Article from California Healthline.

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