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Office of the Patient Advocate – Frequently Asked Questions
We are here to help. This is a list of the most frequently asked questions (FAQs) including links to pages with more detailed information.
I need a patient advocate. Can you help me?
- No. Due to a change in our program responsibilities, our name no longer accurately represents what we do. There is currently no state office or agency that provides direct patient advocate services.
What does OPA do?
- OPA advocates for health care consumer interests by publicly reporting health care quality data. Our aim is to educate consumers so that they can make informed decision and enable them to access the health care services for which they are eligible.
Is OPA the same as the Office of Patient Rights?
- No, the Office of the Patient Advocate (OPA) is a California state office under the California Health and Human Services Agency (CHHS). The Office of Patient Rights is a unit under the Office of Disability Rights of California (DRC). DRC is a nonprofit agency not associated with OPA.
How do I become a patient advocate?
- The patient advocate profession is a new and growing career field. In California, there are currently no state licenses, requirements or accreditation for these positions. However, there are a number of patient advocacy certificate programs offered online and through universities across the United States.
How can I file complaint about my health plan?
- See how to file a complaint and find more information on our complaints page.
How can I file a complaint about my doctor or another medical provider?
- File a quality of care complaint regarding a medical group or a provider through your health plan’s member services.
- File a complaint about a physician to the Medical Board of California or other healthcare provider to the appropriate licensing board.
How can I file a complaint about a hospital or other medical facility?
- For acute care hospitals and nursing home facilities, file a complaint with the California Department of Public Health (CDPH). For assisted living, adult day care, and other types of community care facilities, file a complaint with the California Department of Social Services (DSS).
I already filed a complaint with another state office. Can I also file a complaint with OPA?
- No, OPA does not take complaints. Depending on your issue, we can try to direct you to other helpful resources. See our list of additional resources.
Can OPA do anything to speed up the review or overturn a decision made by another office?
- No. Depending on the situation, we can direct you to the appropriate state office to request a review or appeal of your case. Find more information on contacting a state help center for an appeal here.
Where can I find additional help with filing a complaint?
Where can I get health insurance coverage?
There are various options for obtaining healthcare coverage including coverage at little or no cost to you.
- You can sign up for a health plan through Covered California, California’s health insurance marketplace. Think of this marketplace as California’s online shopping mall for health insurance, it makes it easier to find health plans and choose one that works well for you. Covered California screens for low-cost coverage options and provides premium assistance for those who qualify.
- Visit the Department of Insurance for detailed information on different health insurance options to find what type of coverage best fits your needs.
- You do not have to purchase from the marketplace, health care policies are also available for purchase directly from a health plan or through an insurance broker. Find a local licensed insurance broker here or contact a plan directly for more information.
- Find more information on free and low cost services here.
Whom do I contact if I have a problem using my insurance coverage to get health care services or pay for services?
- Contact your health plan’s member services to file a grievance.
- If you have already filed a grievance with your health plan, you can file an external complaint with the Department of Managed Health Care (DMHC), who oversees most California plans.
Where can I find additional assistance?
- See our list of additional statewide resources or contact your local Health Consumer Alliance for additional assistance.
Does OPA provide advice on mental health rights?
- No. For information on rights for individuals in mental health facilities, refer to this Department of Health Care Services Handbook. For additional assistance regarding mental health treatment and advocacy, contact the Office of Patients’ Rights or your local county Mental Health office. For other mental health rights related questions see here.
Where can I file a mental health related complaint?
- File a grievance against your mental health provider to the Department of Consumer Affairs Board of Psychology or Board of Behavioral Health.
- File a grievance against a mental health facility to the California Department of Public Health Licensing and Certification Program.
Does my doctor have to give me copies of my medical records? Can they charge me for the copies?
- Yes, the Medical Board of California regulates patient access to medical records and you have the right to request access to your medical records within certain guidelines. For more information on guidelines and regulations see here.
- Yes, your doctor can charge you for copying and mailing your records. Visit the Medical Board of California for specific cost information.