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SUMMARY OF THE WASHINGTON STATE HEALTH CARE
PATIENT BILL OF RIGHTS
The Patient Bill of Rights takes effect July 2001, if funded.
Under the Bill, health care insurance plans are required to:
- provide an adequate choice of qualified doctors
and other health-care providers. The plans must also make
timely referrals to medical specialists.
- allow a patient to have repeat visits to a specialist
(e.g. for cancer treatments) without the need to have a
primary care physician (a gate-keeper) make a referral on
each occasion.
- have a grievance process in place for handling
claim disputes. Many plans already have a grievance/appeal
procedure, however, the procedures will now be mandatory
and the procedures will be applied with uniform rules.
Unfortunately,
having rights is not the same thing as benefiting from those
rights. If you are denied coverage and the health insurer
is dragging its feet or requiring you to jump through hoops
to get the care you or a loved one needs, you should seriously
consider consulting a knowledgeable attorney. It is sad, but
true, that an experienced attorney can sometimes successfully
demand that a denial of coverage be reversed with a few telephone
calls or letters. If not, the attorney can demand prompt compliance
with appeal procedures, demand mediation or file a lawsuit.
Because time is often critical, a call to an experienced attorney
should not be put off.
Click
here to read the Washington State Patient Bill of Rights.
Click
here to read the Rules proposed by the Office of the Insurance
Commissioner to implement the "Patient Bill of Rights" Ch.
5, Laws of 2000 (E2SSB 6199).
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