Janise and her staff were very open and made it clear that their business is to solve problems when there are billing disputes. They talked about working with directly with patients who file a complaint and with physician offices who refer patients with billing challenges. Their philosophy is that patients have rights AND responsibilities to understand what benefits are covered under the plan they purchase. They also expressed the belief that both patients and providers have appeal rights.
Specific to NVOS, the office has an ombudsman for injured workers (Charles Quintana). He seemed very conversant with the frustrations your offices experience in being able to treat injured workers in a timely fashion, while fully exercising your clinical judgment. Apparently, his office handles the complaints (again, see page 10) relative to appropriate access for injured workers.
There are also ombudsmen for hospital patients and for Medicare/Medicaid, as well as bi-lingual staff who can assist.
Janise encouraged us to make sure your offices know about these services and feel comfortable in referring patients. Please see the attached brochures, which she suggested you could provide to your patients, as needed.
This is Janise’s contact info:
Janise Wiggins, LSW, MPA, CPM
Governor’s Consumer Health Advocate
State of Nevada Office for Consumer Health Assistance
Office of Minority Health
555 East Washington #4800, Las Vegas, NV 89101
Office: 702-486-3587
E-mail: Janise.Wiggins@govcha.nv.gov
OCHA Request for Assistance 08012012 English