Coping with Managed Care
  How to Fight Your HMO and Win   When care is denied, don’t give up — fight! Superb advice is offered here on how to present your case to the HMO, how to prepare for hearings and appeals, where to find support and what to expect as you go through the process.

    Consumer Support  
    Patient Advocacy Services   New Mexico-based firm specializes in representing individuals and organizations to appeal the denial of payment for care. It’s not clear whether PAS can directly represent persons outside of New Mexico, but there is a wealth of information on this site to assist anyone to deal with an HMO appeal.

    Center for Patient Advocacy   Complex but interesting site offering press releases, support for patient advocates and common-sense advice on how to get competent service out of your HMO.

    Medicare Managed Care  
    How Managed Care Works Under Medicare   The Medicare Handbook, by the Health Care Finance Administration, explains how Medicare provides services through managed care. You won’t find any criticism here, but there is lots of good information about how the program works (or should work).

    Medicare HMO Appeals   Brief discussion of appeals if you receive Medicare coverage through an HMO. Offered by Bet Tzedek Legal Services, a non-profit firm in California.

    Resources for Professionals  
    Insurance Resources   NILS Publishing offers a complete library of insurance statutes and treatises for those who need technical information about the regulation of HMO’s. Order books online.

    Claims Against HMO’s   The Health Administration Responsibility Project offers strategies and legal research to support claims against HMO’s for irresponsible denial of care. Written for lawyers but you will find it interesting if you have a dispute presently with your HMO.


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