Sources of Information

Access and Service

Do health plan members have access to the care and services they need?

You will learn how health plan members rated

• their health plan overall
• their ease of getting a referral to specialists
• the reasonableness of paperwork, handling of approvals and payments
• the efficiency and helpfulness of customer service the courtesy, respect and helpfulness of medical office staff

Are health plan members satisfied with physicians and other providers?

You will learn how health plan members rated

• the quality of care they received
• their personal doctor
• the specialist they see most
• their ease of finding a personal doctor
• their doctor's ability to communicate well

Does the health plan help people maintain good health and avoid illness?

You will learn what portion of

• members were seen by a provider in the past 3 years
• pregnant women in the health plan received early prenatal care
• new mothers in the health plan had a check-up after delivery
• older women in the health plan received a test for breast cancer
• women in the health plan received a test for cervical cancer

How well does the health plan care for people when they become sick?

You will learn how health plan members who used services frequently rated

• their health plan overall
• the quality of care they received
• their ease of finding a personal doctor
• their ability to get care when needed

You will also learn what portion of health plan members

• received an eye exam because they have diabetes and are at risk for blindness
• received care after hospitalization for mental illness

How well does the health plan care for children?

When getting care for their children, you will learn how health plan members rated

• the quality of care their child received
• their child's personal doctor
• their ease of finding a personal doctor for their child
• their doctor's ability to communicate well

You will also learn what portion of children and adolescents in the health plan

• received recommended immunizations

• things to consider when choosing a health plan
• how to get the most from your health plan

• how to appeal a plan's decision
• what to do if you have a complaint

• the role of accreditation organizations
• telephone numbers and types of coverage for all New Jersey plans

• New Jersey Consumer Bill of Rights