The reviewer may ask to speak with the consumer. Such direct contact, however, is rare. It may be difficult to have direct contact with the reviewer and you may be given a phone number or address to express your concerns. Take advantage of any opportunity to speak with a reviewer of your care. The most consumer-sensitive contracts may establish a committee, including consumers and medical providers, to examine areas of dispute and to advise the managed care company.
States wish to control their health care costs.
Before hiring a managed care company for Medicaid services, the State puts out a request for proposals. Generally several managed care organizations submit bids. The State selects one or more of these bidders and signs a contract with one or more managed care companies. For States, this contract is a critical document, a new tool in health care delivery. Consumer advocates will need to play as big a role as possible at the State level before a contract is signed or renewed.