Member Support

Members Rights & Responsibilities

As a member of Torrance Memorial IPA, you have the right to:

Receive information about Torrance Memorial IPA, its services, its practitioners and providers.
Be treated with respect and dignity.
Personal privacy
Participate with practitioners in decision-making regarding your health care.
Candid discussion of appropriate or medically necessary treatment options for your conditions, regardless of cost or benefit coverage.
Request a copy of Torrance Memorial IPA's policies, procedures, and criteria used to make referral decisions by phoning Torrance Memorial IPA member services department.
Voice complaints or appeals about Torrance Memorial IPA or the care provided.
Make recommendations regarding Torrance Memorial IPA's members' rights and responsibilities policies.
Request translation services, interpretative and/or auxiliary aide services (for the sensory impaired) at no cost, to ensure that you have an equal opportunity to access and participate in all services. You have the right to a certified medical interpreter or sign language interpreter to translate health information accurately, who must respect your privacy and keep all information confidential.

As a member of Torrance Memorial IPA, you have the responsibility to:

Supply information (to the extent possible) that Torrance Memorial IPA and its practitioners and providers need in order to care for them.
Follow the plans and instructions for care that they have agreed on with their practitioners.
Understand their health problems and participate in developing mutually agreed upon treatment goals to the degree possible.
Be represented by parent, guardians, family members or other conservators for those who are unable to fully participate in their treatment decisions.

Distribution of Members' Rights and Responsibilities Policy Statement:

Member Information - Members who have already sought medical services from Torrance Memorial IPA practitioners/providers who need additional information on how to obtain care are informed through Torrance Memorial IPA's member services department.
A list of our practitioners and providers with their addresses and telephone numbers is provided to members upon their request and is also available on www.Torrance Memorial IPA.org/Doctors.

Claims, Appeals, or Grievances

You can file a Grievance and Appeal with your Health Plan by Phone, Mail, Fax and Online. Click on: "Health Plan Grievance Info" for a list of all Health Plans contracted with Torrance Memorial IPA with instructions on how to file a Grievance and Appeal with each of them.

If you need further assistance, Call:

Torrance Memorial IPA Member Services
Toll-Free: (866) 568-4472
Local: (310) 257-7250, press 1
TTY/TDD: 711
Monday - Friday: 8:30 a.m. - 5:00 p.m.

When you call Member services at the number above, feel free to ask for the Member Services Representative who is specialized in your health plan.

Affirmative Statement About Incentives

Utilization Management (UM) decision-making is based only on appropriateness of care and service and existence of coverage.

Torrance Memorial IPA does not specifically reward practitioners or other individuals for issuing denials of coverage or service care.
There are no financial incentives for UM decision-makers; therefore there is nothing to encourage decisions that result in underutilization.

All requested service(s) or medical care for members of Torrance Memorial IPA, are based solely on what is appropriate and a covered benefit for the member as detailed by his or her health plan.

Language Assistance Program

Request interpreter services

If your patient needs interpreter services for any language, call Provider Services at (800) 541-6652. California health plans provide free of charge to all their members, oral interpretive services to LAP members at all medical points of contact. This does not apply to senior members.

Health Plan Oral Translation Services

Aetna		Oral Interpretation Contact Number
		(877) 287-0117

Anthem Blue Cross		Oral Interpretation Contact Number
		(888) 254-2721

Blue Shield of CA		Oral Interpretation Contact Number
		(866) 346-7198

Blue Shield Promise Health Plan		Oral Interpretation Contact Number
		(800) 544-0088

Cigna		Oral Interpretation Contact Number
		(800) 244-6224

Health Net		Oral Interpretation Contact Number
		(800) 546-4570 After Hours Interpreter Assistance (6:00 pm- 8:00 am)

Humana		Oral Interpretation Contact Number
		(800) 457-4708

Scan Health Plan		Oral Interpretation Contact Number
		(800) 559-3500

United Healthcare		Oral Interpretation Contact Number
		(800) 624-8822

Tips for Working with Telephonic Interpreters

Telephonic interpreter services allow for immediate contact with a professional interpreter. Here are some strategies to optimize communication:

If possible, speak to the interpreter privately prior to the contact, providing relevant information regarding the member and the important information to convey.
Interpreters are not allowed to rephrase or clarify. Encourage the interpreter to request clarification or to redirect explanations as needed.
Direct the conversation to the member, not the interpreter.
- Use short sentences limited to a single concept if possible.
- Allow adequate time for the interpreter to convey the information in the member’s language.
Avoid medical jargon or technical explanations unless they are requested by the member.
- Avoid interrupting the interpreter.

If the member’s non-verbal cues indicate confusion, ask the member to summarize or restate what has been communicated.

We at Torrance Memorial IPA sincerely hope this information is useful in your everyday encounters with Limited English Proficient members.