HOW DO I...

Get recommendations from friends and family. Your relationship with your healthcare provider is important. Ask your family, friends, neighbors, or church community if they like their healthcare provider, then get their contact information.

Search for providers online. Search sites like www.healthgrades.com or www.vitals.com to read reviews for local providers, or visit www.medifind.com to find specialists.

• To find a Black provider, try:
  • BlackDoctor 24/7
  • BlackDoctor.org

• To find a Black mental health provider, try:
  • Black Virtual Wellness Directory 
  • Clinicians of Color 
  • InnoPsych 
  • Therapy for Black Girls 

Check for coverage. Make sure your chosen provider is covered under your health insurance. Most plans charge more for a provider that is outside their network. Call your plan or visit their website to check if a provider is in-network. 

Check quality. According to the Listening to Black Californians study, about 1 in 3 Black Californians say they’ve been treated poorly by a provider because of their race or ethnicity. Before seeing a new provider, check if other patients had complaints at the Office of the Patient Advocate (OPA) or www.docinfo.org. 

After you have a visit with a healthcare provider, ask yourself these questions:

• Was I treated with respect and dignity?
• Did they answer all my questions?
• Did they explain things in a way I understood?
• Did they take my symptoms and my pain seriously?
• Were they calm and understanding? Did they give me enough time?
• Did they consider my beliefs, identity, and culture while discussing my health?

Learn more about a provider. When you find a provider, call their office and ask questions you may have, such as:

• Are you taking new patients?
• Are you part of a group practice where I might see other providers?
• Is there someone who speaks my preferred language?
• How far in advance do I have to make an appointment?
• Do you offer same-day, evening, weekend, or virtual visits?
• Can I get lab work and x-rays done in the office?
• What is your visit cancellation policy? Is there a fee if I miss a visit?

Your plan will send your insurance card in the mail. Your card is very important because:

• It proves to healthcare providers that you have insurance.
• It lists the amount you need to pay each time you get different types of health care.

Some plans require your card at visits, while others don’t. But always keep your card with you in case of an emergency.

When you sign up for a health plan, you will get a ‘summary of benefits and coverage’ (SBC). An SBC is a written summary of the health services your plan covers (your benefits) and what you will pay out of your own pocket.

Tip: Store your SBC and other insurance and medical papers together in a safe place.

Every time you get health services, you’ll get a statement from your health plan by mail or email. It shows how much your plan paid for and how much you may owe (if any). These may be called an ‘explanation of benefits’ (EOB), ‘summary notice’ or something else.

Compare your statements to any provider bills you get:

• Make sure you actually got the health services listed and check how much you may owe to the provider.
• When you get a bill, make sure the bill matches the “amount you owe” on your statements.
• Keep your statements for your records.

If you see a mistake, don’t understand your statements, or your plan is not paying for health services you think should be covered, call your health plan. It is your right to speak up when you have questions! When you call:

• Have your list of questions ready.
• Have your insurance card with you.
• Take notes about the call, including the date and name of the person you talk with.
• After the call, put the notes with your other insurance papers.

If your health plan makes a coverage decision that you think is wrong:

• Call them to make sure you understand their decision – you may be able to fix the issue by phone. If needed, politely but firmly ask to speak to a supervisor or manager.
• If they still don’t fix the issue, file an appeal. An appeal is a request you make to your health plan to change its decision about your plan coverage. You should only file an appeal if you think the plan made a mistake – not because you don’t like their decision.

Find instructions for filing appeals on your health plan’s website. The health plan will send you their decision and explain how to ask for a second review if they didn’t change their decision.

Health visits can be short, so use these steps to get the most out of them: 

• Prepare ahead of time:
  • Write down your questions and any symptoms.
  • Bring your insurance card. 
  • Bring a list of all of your medicines. 
  • Ask someone to go with you to help remember what the provider says. 

• During your visit:
  • Start with your most important questions in case you run out of time.
  • Write down or record your provider’s answers, especially any actions you need to take. 
  • Check that you understand by repeating information in your own words. You can say:
    • “I think what you are saying is… is that right?”
    • “I want to make sure I understand… did I get that right?” 

• After your visit: 
  • Follow any health advice or instructions, such as filling a prescription at the pharmacy, getting tests or lab work, or scheduling a follow-up. 
  • Call your provider if:
    • You have any side effects from medicines 
    • Your symptoms get worse 
    • You haven’t gotten test results (Don’t assume no news is good news!) 
    • You don’t understand your test results or how to take a medicine

Clearly communicate with your providers.
Healthcare providers can include primary care doctors, nurses, social workers, and more.

Some Black patients say they minimize their symptoms and questions to avoid being seen as difficult at their visits. As patients, it can be hard to speak up. But if we don’t, we don’t get the care we need and deserve.

Here are some ways to communicate clearly with your provider:

Prepare for your visit:

• Speak up:
  • Be assertive but respectful – if you ever feel your provider is dismissing important issues, use “I” statements. For example, say “I disagree” instead of “You’re wrong.”
  • Don’t minimize your symptoms or situation – if something feels important, it is.

• Do your own health research before and after a visit: Read about your symptoms, treatment options, or tests online from trusted sources such as mayoclinic.org or medlineplus.gov. This can help you have an informed discussion around your questions and the terms your provider may use.

Know your rights as a patient.
Everyone, regardless of race, ethnicity, or other characteristics, has rights as a patient that are protected by law. Your rights include being able to:

• Get a second opinion about a diagnosis or treatment from another provider.
• File a complaint. If you feel mistreated or disrespected, chances are you’re not alone. It’s up to all of us to hold our providers accountable. Filing a complaint helps establish a record of misconduct.
• Choose your own provider. A good provider treats you with respect, doesn’t rush you, and makes eye contact. It’s your choice to switch providers when it’s not a good fit.
• Access your medical records. Did you know you can add your own notes to your medical records? You have the power to set the record straight. If your provider denies a test or treatment that you asked for, make sure that goes in your record. It’s your health and your medical record—remember that.
• Keep your medical information private. Your medical information is just that—yours. You can set limits on who sees your information, and on when and how your providers contact you.

See a full list of your rights in California here.

File a complaint if something goes wrong.
Some Black Californians say their privacy was not respected or they were harmed during a health care visit. If this ever happens, it’s your right to file a complaint. Providers need to be held accountable for their actions. Sharing your complaints can prevent this in the future.

You can file a complaint with your state’s medical board if your provider has:

• Failed to give you proper care
• Failed to diagnose you with a medical problem that is found later
• Prescribed you the wrong medicines
• Acted in an unprofessional way

In California, you can file a complaint about a provider at www.mbc.ca.gov/Consumers/file-a-complaint.

If your health plan denies, changes, or delays coverage for medical services that you think should be covered, you can:

1. File a complaint with your health plan first. Learn how to file a complaint at www.dmhc.ca.gov/File-a-Complaint/Contact-Your-Health-Plan.aspx
2. Then you can apply for an Independent Medical Review (IMR). An IMR is when a medical professional reviews a decision of your health insurance company. The Department of Managed Health Care Help Center can help with an IMR at www.dmhc.ca.gov/FileaComplaint.aspx

Talk to a patient advocate.
Patient advocates, also called patient navigators or liaisons, are people who can help you use the healthcare system. They can help you:

• Set up appointments and talk with your providers
• Understand provider instructions and test results
• Understand your health plan
• Get financial help
• File complaints about your care and more

There are different types of patient advocates:

• Advocates hired by hospitals, health care facilities, or insurance companies to help patients within that facility or company – this is usually free.
• Private advocates with their own businesses who offer one-on-one help to patients at different facilities – this is usually not covered by insurance, and costs money.

To get help from a patient advocate:

• In a hospital or health care facility, ask patient services if they have advocates that can help you while you are there.
• Ask your health plan if they can offer a case manager to help you with insurance issues.
• Visit these sites to help you look for a private advocate:
  • The National Association of Healthcare Advocacy (NAHAC) directory at nahac.com/directory-of-advocates#!directory
  • The AdvoConnection directory at profile.advoconnection.com
  • The Patient Advocate Foundation offers free support to patients and families living with a serious or chronic health condition. Visit them at www.patientadvocate.org