Consumer's Guide to Healthcare Providers

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Contents

Part 1

• Introduction
• Licensed healthcare professionals
• DCA healthcare licensing entities

Part 2

• Selecting a healthcare provider
• How to find a doctor
• How to find a dentist
• How to find a mental health provider
• How to select a hospital
• How to select a nursing home

Part 3

• How to handle problems
• Hospital complaints
• Problems with your health plan
• Patients' rights

Part 4

• Medical identity theft
• How to spot it
• More resources

Introduction

Today’s consumers have a wide range of choices in healthcare services, from traditional medical care to practices such as naturopathic and acupuncture. Because there are so many choices, it’s more important than ever for consumers to be well-informed. Your health—and your money—depend on it.

Entities of the California Department of Consumer Affairs license and regulate more than 19 different types of healthcare professionals, from doctors and nurses to hearing aid dispensers, psychologists, and others. In all, more than 900,000 healthcare professionals are licensed in California by DCA entities.

You may not need every type of licensed health professional listed in this guide, but it’s important to know what they are and what they do. To be licensed in California, healthcare professionals must meet minimum standards for education, training, and experience, plus pass professional exams and criminal background checks.

You can verify the license of any DCA-licensed healthcare professional by going online to www.dca.ca.gov. Click on “Verify a License.” Information available to the public may include disciplinary action taken against the license holders.

Please note
The following pages contain general descriptions of each type of healthcare professional. Contact the specific licensing entity for more information.

Licensed Health Professionals

Acupuncturists
Acupuncturists treat health conditions by stimulating “acu-points” on the body. Acupuncturists do this by inserting very thin needles through the skin or by using heat or finger pressure. Acupuncture Board, www.acupuncture.ca.gov, (916) 515-5200.

Audiologists
Audiologists evaluate, diagnose, treat, and manage hearing loss and balance disorders. Some audiologists also fit and sell hearing aids. Speech-Language Pathology and Audiology and Hearing Aid Dispensers Board, www.speechandhearing.ca.gov, (916) 263-2666.

Chiropractors
Chiropractors diagnose and treat patients with problems of the musculoskeletal system and treat the effects of those problems on the nervous system and on general health. Many chiropractic treatments deal specifically with the spine. Board of Chiropractic Examiners, www.chiro.ca.gov, (916) 263-5355 or (866) 543-1311.

Clinical social workers
Clinical social workers work in health facilities, private practice, and child welfare agencies. They use counseling and psychotherapeutic techniques to assist individuals, couples, families, and groups. They often refer clients to specific resources to improve their quality of life. Board of Behavioral Sciences, www.bbs.ca.gov, (916) 574-7830.

Contact lens dispensers/spectacle lens dispensers
Both types of dispensers must by registered by the Board of Optometry. Technicians who fit or adjust contacts or glasses under the supervision of a physician or optometrist do not need to be registered. Board of Optometry, www.optometry.ca.gov, (916) 575-7170 or (866) 585-2666.

Dental assistants
This classification includes unlicensed dental assistants, registered dental assistants, and orthodontic assistants, all of whom perform basic supportive dental procedures under the supervision of a licensed dentist or a licensed dental hygienist. Dental Board of California, www.dbc.ca.gov, (916) 263-2300 or (877) 729-7789.

Dental hygienists
Dental hygienists clean teeth and provide preventive dental care, as well as teach patients how to practice good oral hygiene. Dental Hygiene Committee of California, www.dhbc.ca.gov, (916) 263-1978.

Dentists
Dentists diagnose and treat diseases, injuries, and malformations of the teeth, jaw, and mouth. Dentists can specialize in orthodontics, pediatric dentistry, or periodontics. Dentists who hold an Elective Facial Surgery Permit may perform certain facial cosmetic surgery procedures. Dental Board of California, www.dbc.ca.gov,(916) 263-2300 or (877) 729-7789.

Educational psychologists
Educational psychologists work in schools or in private practice and provide educational assessment and counseling relating to academic ability, behavior, and other matters. Board of Behavioral Sciences, www.bbs.ca.gov, (916) 574-7830.

Hearing aid dispensers
Hearing aid dispensers fit or sell hearing aids. Speech-Language Pathology and Audiology and Hearing Aid Dispensers Board, www.speechandhearing.ca.gov, (916) 263-2666.

Marriage and family therapists
Marriage and family therapists work in clinics, counseling centers, and private practice. They use counseling or psychotherapeutic techniques to assist individuals, couples, families, and groups with marriage, family, and relationship issues. Board of Behavioral Sciences, www.bbs.ca.gov, (916) 574-7830.

Midwives
Midwives licensed by the Medical Board of California attend cases of normal childbirth under the supervision of a licensed physician. Certified nurse midwives, licensed by the Board of Registered Nursing, perform similar services. Medical Board of California, www.mbc.ca.gov, (916) 263-2382 or (800) 633-2322; Board of Registered Nursing, www.rn.ca.gov, (916) 322-3350.

Naturopathic doctors
Naturopathic doctors are primary care providers who diagnose and treat acute and chronic conditions. They use herbs, supplements, vitamins, homeopathic remedies, nutritional counseling, prescription medicines, and other treatments to help the body heal itself. California Board of Naturopathic Medicine, www.naturopathic.ca.gov, (916) 928-4785.

Nurse practitioners
Nurse practitioners are registered nurses who have additional education and training in diagnosis, psychosocial assessment, and management of health or illness needs. They help manage acute and chronic conditions, furnish medications, and educate and counsel patients on healthcare matters. Board of Registered Nursing, www.rn.ca.gov, (916) 322-3350.

Occupational therapists
Occupational therapists work with people experiencing different medical conditions or disabilities to develop, improve, or restore functional daily living skills. Board of Occupational Therapy, www.bot.ca.gov, (916) 263-2294.

Ophthalmologists
Ophthalmologists are eye surgeons who perform surgeries for problems caused by diseases such as cataracts, glaucoma, and macular degeneration. They also treat eye diseases and prescribe corrective lenses. Medical Board of California, www.mbc.ca.gov, (916) 263-2382 or (800) 633-2322.

Opticians
Registered dispensing opticians run businesses that fill prescriptions for eyeglasses and contact lenses. Opticians cannot prescribe corrective lenses. Medical Board of California, www.mbc.ca.gov, (916) 263-2382 or (800) 633-2322.

Optometrists
Optometrists conduct examinations to determine the overall health of the eyes. Optometrists screen for diseases and prescribe corrective lenses. Board of Optometry, www.optometry.ca.gov, (916) 575-7170 or (866) 585-2666.

Osteopathic physicians
Osteopathic physicians diagnose illness, prescribe medicine, and perform surgery similar to medical doctors. An osteopathic physician puts special emphasis on the role of the bones, muscles, and joints in the healthy functioning of the body. Osteopathic Medical Board of California, www.ombc.ca.gov, (916) 928-8390.

Pharmacists
Pharmacists dispense prescribed drugs to individuals, They also advise patients and healthcare professionals on the selection, dosages, interactions, and side effects of medications. California State Board of Pharmacy, www.pharmacy.ca.gov, (916) 574-7900.

Pharmacy technicians
Pharmacy technicians provide administrative or technical support and customer service. They work under the supervision of pharmacists. California State Board of Pharmacy, www.pharmacy.ca.gov, (916) 574-7900.

Physical therapists
Physical therapists use exercise programs and other methods to relieve pain, improve movement, maintain cardiopulmonary function, and limit disabilities. Physical Therapy Board of California, www.ptbc.ca.gov, (916) 561-8200.

Physicians and surgeons
Physicians and surgeons are medical doctors who practice in a range of specialties. Medical Board of California, www.mbc.ca.gov, (916) 263-2382 or (800) 633-2322.

Physician assistants
Physician assistants work with supervising physicians to provide patient evaluation, education, and other healthcare services. Physician Assistant Board, www.pab.ca.gov, (916) 561-8780.

Podiatric medical doctors
Doctors of podiatric medicine diagnose and treat conditions affecting the foot, ankle, and related structures of the leg. California Board of Podiatric Medicine, www.pmbc.ca.gov,(916) 263-2647.

Professional clinical counselors
Professional clinical counselors use counseling interventions and psychotherapeutic techniques to treat cognitive, mental, and emotional issues, including personal growth, adjustment to disability, crisis intervention, and psychosocial and environmental problems. Board of Behavioral Sciences, www.bbs.ca.gov, (916) 574-7830.

Psychiatric technicians
Psychiatric technicians practice under physicians, psychologists, registered nurses, social workers, or other related professionals. They work at hospitals, day treatment centers, and residential care facilities. Board of Vocational Nursing and Psychiatric Technicians, www.bvnpt.ca.gov, (916) 263-7800.

Psychiatrists
Psychiatrists are physicians who specialize in prevention, diagnosis, and treatment of mental disorders. They work in private practice, hospitals, and clinics. Medical Board of California, www.mbc.ca.gov,(916) 263-2382 or (800) 633-2322.

Psychologists
Psychologists work in hospitals, clinics, counseling centers, or private practice. They provide individual, family, or group psychotherapy and design and implement behavior modification programs. Board of Psychology, www.psychology.ca.gov, (866) 503-3221 or (916) 574-7720.

Registered nurses
Registered nurses provide care that ensures patient safety, comfort, personal hygiene, protection, and disease prevention. They also administer medications ordered by a physician, dentist, or other authorized healthcare provider. Board of Registered Nursing, www.rn.ca.gov, (916) 322-3350.

Respiratory therapists
Respiratory therapists treat lung and breathing disorders. They consult with physicians, analyze tissue and blood samples, and manage artificial breathing devices for patients who cannot breathe on their own. Respiratory Care Board of California, www.rcb.ca.gov, (866) 375-0386 or (916) 999-2190.

Speech-language pathologists
Speech-language pathologists screen, assess, and treat adults and children who have speech, language, or swallowing disorders. Speech-Language Pathology and Audiology and Hearing Aid Dispensers Board, www.speechandhearing.ca.gov, (916) 263-2666.

Vocational nurses
Vocational nurses provide patient care under physicians and surgeons or registered nurses. Board of Vocational Nursing and Psychiatric Technicians, www.bvnpt.ca.gov, (916) 263-7800.

DCA healthcare licensing entities

Selecting a healthcare provider

How to find a doctor

Selecting a doctor for yourself or your loved ones often begins with your group or individual health plan. In most cases, your plan will have a list of doctors that accept your insurance and tips on how to select one.

Here are some tips from the Medical Board of California on choosing a doctor:

• You may want to talk with friends or co-workers about physicians they like. Most county medical societies will also give you names of physicians in your area who are in the specialty you seek. Look in the white pages of your phone directory for your county medical society or association.
• Once you have some names, call the doctors’ offices and ask if they are accepting new patients. Be sure to ask whether they will accept your insurance plan.
• Ideally, you should meet the physician and discuss your health concerns while you are well. This may be a good time to have a history and physical examination performed, but make sure your insurance will cover the cost. Most plans will not cover an informal visit just to get acquainted.
• Before you make an appointment, call the Medical Board at (800) 633-2322 or go online to www.mbc.ca.gov to verify that the doctor has a current California license.
• Board specialty certification is granted by the American Board of Medical Specialties. To verify a doctor’s Board certification, call (866) 275-2267 or go online to www.abms.org.

How to find a dentist

If you are covered by a dental insurance plan, your provider will have a list of dentists who accept your coverage. The California Dental Association maintains an online directory that can help you find a dentist in your area. View the directory at www.cda.org. Be sure to ask if the dentist is accepting new patients when you call for an appointment. You can confirm a dentist’s license with the Dental Board of California, www.dbc.ca.gov, (877) 729-7789 or (916) 263-2300.

How to find a mental health provider

The Board of Behavioral Sciences has a list of referral services to help you find licensed mental health professionals in your area. View the list online at www.bbs.ca.gov/consumers/info.html.

Self Empowerment – Choosing a Mental Health Professional in California is a consumer publication from the Board of Behavioral Sciences. Find it online at https://www.bbs.ca.gov/pdf/publications/self_empowerment_booklet_eng.pdf.

For Your Peace of Mind–A Consumer Guide to Psychological Services, a publication from the California Board of Psychology, includes tips on how to select a mental health professional. View the publication online at www.psychology.ca.gov/forms_pubs/consumer_guide.pdf.

How to select a hospital

The doctor who is treating you may decide which hospital is appropriate for your care. Even if you don’t choose the hospital yourself, you may wish to check on how the hospital is rated by the California HealthCare Foundation. Find ratings and more information at www.calqualitycare.org.

How to select a nursing home

Medicare’s Guide to Choosing a Nursing Home provides information to help you make informed decisions about nursing home care. The guide is available online at www.medicare.gov/nursinghomecompare/search.html.

The California Department of Public Health has consumer information on nursing home residents’ rights, how to choose a nursing home, and other matters. Find the information online at https://www.cdph.ca.gov/Programs/CHCQ/LCP/Pages/NHA.aspx.

How to handle problems

Complaints about a licensed healthcare professional should be filed with the appropriate licensing entity. Here are some tips on how to handle complaints about other healthcare matters.

Hospital complaints

Consumers who have disputes with hospitals about medical care, billing practices, or charges should try to resolve problems by contacting the hospital’s management care consultant or patient advocate.

Problems with your health plan

If you have a problem with your health plan or health maintenance organization, you should contact your health plan first to file a complaint. If you have not received a response to your complaint within 30 days (within three days if the problem is urgent), or if you are not satisfied with your health plan’s decision, contact the Help Center at the California Department of Managed Health Care, www.dmhc.ca.gov, (888) 466-2219.

Patients’ Rights

Information on your rights under California law and what to do if you have a problem is available from the California Office of the Patient Advocate (OPA). Health Care Quality Report Cards, compiled by OPA, are available online. https://www.opa.ca.gov/ReportCards/, (866) 466-8900.

Medical identity theft

Medical identity theft means your name may be used fraudulently to:

• File false claims to get payments from health insurance companies and government programs such as Medicare.
• Obtain prescription medications that are then sold on the black market.
• Obtain medical treatment, exams, or even surgeries.

While the first two types of identity theft are for financial gain, the third type can be dangerous for you. If someone uses your name to obtain medical services, that person’s medical information may end up in your file. You medical record could show you are taking different medications, have different allergies, or even have a different blood type. Misinformation like that can cause medical personnel to give you treatment or medications which could cause you serious harm.

Another danger of medical ID theft, according to the Federal Trade Commission (FTC ), is that debt collectors could come after you for the scammer’s unpaid medical debts. Your credit will suffer if medical bills are not paid.

There are ways to spot medical identity theft early on. Here are some tips from the FTC.

• First, read the “Explanation of Benefits” statement you get from your health insurer. Follow up on any item you don’t recognize.
• At least once a year, ask the health insurers you’ve been involved with for a list of the benefits they paid in your name.
• Finally, make it a regular practice to check your credit reports. You’re entitled to a free report from each of the three nationwide companies every 12 months. That will help you monitor any unpaid medical bills that are falsely charged to you. You can order your free credit report at https://www.annualcreditreport.com/index.action.

The privacy of your healthcare records is protected by a Federal law known as the Health Insurance Portability and Accountability Act (HIPPA). The law applies to certain healthcare providers such as doctors, dentists, chiropractors, and pharmacies. It also covers all health insurance companies and health maintenance organizations (HMOs), company health plans, and government programs that pay for healthcare, including Medicare, Medi-Cal, and military and veterans healthcare programs.

In general, the law:

• Defines your rights over your health information.
• Sets rules and limits on who is allowed to receive and/or view your health information.

More information about medical identity theft is available from the Federal Trade Commission, www.consumer.ftc.gov.

For tips on how to prevent Medicare fraud and how to report suspected fraud, call (800) 447-8477 or go online to https://stopmedicarefraud.org.

Summary

In the marketplace, a well-informed consumer is a well-armed consumer. The same is true for consumers of healthcare. A wide range of information on healthcare professionals and institutions is available to help you make the best healthcare choices and decisions for yourself and your loved ones. The next step is up to you.