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Psychiatric Practice & Managed CareFull Access

Managed Care Complaints

Published Online:https://doi.org/10.1176/pn.39.5.0025a

The Managed Care Help Line, which is staffed by the Office of Healthcare Systems and Financing, handled more than 1,135 calls from members in 2003, 171 of which represented intensive case work to resolve managed care issues. Of those, nearly 88 percent of the complaints were resolved.

According to Karen Sanders, manager of the Help Line, APA received about 60 percent fewer managed care complaints in 2003 than in 2002. Although there was a slight decline in Help Line activity overall in 2003 compared with previous years (1,677 calls in 2002, and 1,257 calls in 2001), Sanders hopes psychiatrists will continue to pick up the phone and let APA know when they encounter problems with insurers or pharmacy benefit managers. “We can’t help if we don’t know about the problem,” she said.

Call the Managed Care Help Line at (800) 343-4671.