BY JUDY LIN-EFTEKHAR
UCLA Today Staff

Bridget Sheehan-Watanabe, UCLA's health-care facilitator.

Confusing. Frustrating. Sometimes downright maddening. Bridget Sheehan-Watanabe knows what it’s like to grapple with problems with health-care plans, from billing disputes to denials of needed care. Before joining UCLA in August as UCLA’s first-ever health-care facilitator, she had spent years as an attorney and policy analyst for such organizations as the Health Rights Hotline and the Center for Health Care Rights and helping members of her own family negotiate through the health-care maze.

“I’ve had a long-standing interest in health care,” she said. “There’s not much that somebody can come to me with that I haven’t already dealt with myself.”

The position of health-care facilitator was newly created UC-wide to provide advocates and educators to all employees — active and retired faculty and staff and their dependents — covered by university health plans, including dental and eye care.

By the time UCLA employees come to Sheehan-Watanabe, most have endured hours of frustration trying to solve the problem on their own.

“It’s very complicated,” she said. “That’s one of the reasons why people need help with it.”
Billing problems are common, she said. It’s not unusual, for instance, for people to be billed for services that should have been covered. “Or they just can’t figure out what their bills are for,” she said.

Specialist referrals are another frequent difficulty — from getting a referral approved in the first place to waiting months to actually get an appointment.

“Health plans are obligated to provide services in a reasonably timely manner,” Sheehan-Watanabe said. “But I can’t force a specialist to give someone an earlier appointment.”
She can, however, recommend strategies to patients, such as asking to be placed on a cancellation list at the specialist’s office or requesting their primary-care physician to help them get an expedited appointment. “And then they can also go back to the medical group and the health plan and make a complaint about accessibility of services,” Sheehan-Watanabe noted.

In one recent case, Sheehan-Watanabe worked with an employee with cancer who was being denied access to an appropriate specialist. She was able to help the employee get approval for a specialist, who recommended immediate surgery to stop the course of the disease.
Sheehan-Watanabe will also provide employees with resource materials, from sample letters to contest a denial of service, to step-by-step advice on how to select a specialist. She wants to develop a broad range of consumer materials that could be useful throughout the UC system.

She also is collecting data for reports on problems with health plans that might be occurring systemwide. “We want to both advocate for change and inform the university about its health plans, which will help it with contracting.”

Sheehan-Watanabe said she finds great satisfaction in her new position.

“I like doing this for people. People dealing with a health condition have a difficult enough time without having problems with a health plan. The health care should be working the way it’s supposed to. I like being able to make that happen and reduce some of their stress.”
If you’re having difficulty with a health plan problem, contact Sheehan-Watanabe at bsheehan@chr.ucla.edu.