You may file a complaint or grievance via phone, fax or mail: Call 1-844-626-6813 and TTY 1-844-349-8916 Fax 1-844-873-7451 Write and mail to PA Health & Wellness, Attention Complaint and Grievance Unit, 300 Corporate Center Drive, Camp Hill, PA 17011
How do I file a complaint against a Medicare provider?
Contact your Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) for complaints about the quality of care you got from a Medicare provider. Like being given the wrong drug or being given drugs that interact in a negative way.
How do I file a complaint with the Pennsylvania Department of Health?
You have the right to file a complaint with the Pennsylvania Department of Health and/or the Pennsylvania Insurance Department if you have a problem getting the services you need, including quality and affordable health care. To file a complaint you must first complete your health plan’s appeal process.
How do I file a complaint with the insurance department?
File a complaint with the Insurance Department online here or request a form here. Call the Insurance Department’s helpline: 1 (877) 881-6388. You can expect the investigator to contact you within 30 days.
How do I file a complaint against a home health agency?
To file a complaint about your doctor (like unprofessional conduct, incompetent practice, or licensing questions), contact your State medical board. If you have a complaint about the quality of care you’re getting from a home health agency, call the home health agency and ask to speak to the administrator.
What is considered a grievance in Medicare?
A grievance is an expression of dissatisfaction (other than an organization determination) with any aspect of the operations, activities, or behavior of a Medicare health plan, or its providers, regardless of whether remedial action is requested.
How can Medicare problems be resolved?
Your plan is the best resource to resolve plan related issues. Call 1-800-MEDICARE. Call 1-800-633-4227, TTY users should call 1-877-486-2048. If your concern is related to Original Medicare, or if your plan was unable to resolve your inquiry, contact 1-800-MEDICARE for help.
How do I file a medical complaint in PA?
File a complaint with the Attorney General's Health Care Section by: Calling – 1-877-888-4877, mailing in a PDF or submitting an ONLINE Complaint.
What is the best way to contact Medicare?
1-800-MEDICARE (1-800-633-4227) For specific billing questions and questions about your claims, medical records, or expenses, log into your secure Medicare account, or call us at 1-800-MEDICARE.
What is a Medicare ombudsman?
The Medicare Beneficiary Ombudsman helps you and your representatives with questions and complaints. They make sure information is available to help you: Make health care decisions that are right for you. Understand your Medicare rights and protections.
How do I ask Medicare a question?
For questions about your claims or other personal Medicare information, log into (or create) your secure Medicare account, or call us at 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.
What does filing a complaint with the attorney general do?
After a complaint is filed, it is reviewed by an attorney general representative who determines whether: The complaint is appropriate for mediation by the office. If it should be referred to another governmental entity that may be more suited to assist with the consumer's complaint. Or both depending on the situation.
Who can you complain to about a doctor?
If you wish to complain about your GP, dentist, opticians or pharmacy service you can do so by contacting NHS England by email NHS England at [email protected] and more information can be found on their website.
How do I file a complaint with the PA Attorney General?
You can download a complaint form from our website at www.attorneygeneral.gov or you can call our toll-free number, 1.800. 441.2555, to have a form mailed to you.
How does Medicare Helpline work?
The Medicare Coverage Hotline is a private for-profit lead generation campaign and does not offer insurance and is not an insurance agency or broker. Your call is sold to a licensed insurance agent to give you information about your Medicare Advantage Plans.
When should I contact Medicare?
Generally, we advise people to file for Medicare benefits 3 months before age 65.
Does Medicare have a chat line?
Medicare.gov Live Chat is available 24 hours a day, 7 days a week, except some federal holidays.
Complaints about the quality of your care
Contact your Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) for complaints about the quality of care you got from a Medicare provider.
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For questions about a specific service you got, look at your Medicare Summary Notice (MSN) or log into your secure Medicare account . You can file an appeal if you disagree with a coverage or payment decision made by one of these:
How to file a complaint about nursing home care?
To file a complaint about improper care or unsafe conditions in a hospital, home health agency, hospice, or nursing home, contact your State Survey Agency. The State Survey Agency is usually part of your State department of health services.
How to complain about home health?
If you have a complaint about the quality of care you’re getting from a home health agency, call the home health agency and ask to speak to the administrator. If you don’t believe your complaint has been resolved, call your state home health hotline. Your home health agency should give you this number when you start getting home health services.
What is an improper care complaint?
Improper care or unsafe conditions. You may have a complaint about improper care (like claims of abuse to a nursing home resident) or unsafe conditions (like water damage or fire safety concerns).
Insurance Information
Did you file a formal appeal (complaint/grievance) with your health plan?
PLEASE READ CAREFULLY
The Attorney General cannot act as your private attorney. As a law enforcement agency, the primary function of the Office of Attorney General is to represent the public at large by enforcing laws including those prohibiting fraudulent, deceptive, confusing or misleading trade practices.
How do I file a Medicare complaint?
The process for filing a Medicare complaint depends on the type of issue you wish to complain about.
How to file a complaint with Medicare Advantage?
If you have a complaint about your Medicare Advantage (Medicare Part C) plan or Medicare Part D prescription drug plan, contact your plan carrier directly or follow the plan’s instructions for filing a complaint located in your plan’s membership materials .
What is Medicare appeal?
A Medicare appeal concerns an issue with Medicare’s refusal to cover a specific service, device, supply or prescription. You might file a Medicare appeal if you need a certain treatment that Medicare doesn’t typically cover, but you think Medicare should cover it. Filing an appeal doesn’t guarantee that Medicare will cover your treatment or item.
How to contact Medicare Help?
Your local SHIP can help with filing a Medicare complaint. To contact your state health insurance assistance program, visit this page and then select “Find Local Medicare Help” in the upper right-hand corner.
How long does it take for a supplier to respond to a complaint?
They then must send you the result of their investigation and response in writing within 14 days.
How to contact the state survey agency?
To contact your State Survey Agency, call the phone number associated with your state.
Can a beneficiary file a complaint with Medicare?
A beneficiary might file a Medicare complaint over any of the above issues, such as receiving an erroneous bill from a doctor’s office, or for other related situations.
How to file a complaint with a health insurance company in Pennsylvania?
Follow the steps below to file a complaint and appeal with your health plan: Call the member/customer service phone number for your health plan. Tell them you want to file a formal complaint and then explain the problem.
How to file a complaint against a health insurance company?
The first thing you need to do is file a complaint with your health plan. Most health plans in Pennsylvania have a two-level appeal process to handle grievances and complaints. Follow the steps below to file a complaint and appeal with your health plan: 1 Call the member/customer service phone number for your health plan. 2 Tell them you want to file a formal complaint and then explain the problem. 3 You can also file your complaint by letter, email, or online through your health plan’s website (see below). 4 If you disagree with your health plan’s decision, you have the right to an internal appeal.
What happens if you disagree with a health plan decision?
If you disagree with your health plan’s decision, you have the right to an internal appeal.
Where to send a statement of complaint in Pennsylvania?
You may request a Statement of Complaint Form by mail, by calling the Professional Compliance Office Hotline at 1-800-822-2113 (if you are calling from within Pennsylvania) or at 1-717-783-4854 (if you are calling from outside Pennsylvania). Return the completed form to the Professional Compliance Office at: Department of State, Professional Compliance Office, PO Box 69522, 2601 North Third Street, Harrisburg, PA 17106-9522. Be sure to include any attachments and supporting documents (legible copies, no originals) that you wish to provide in support of your complaint.
How long does it take to file a complaint against a licensee?
The Order to Show Cause sets forth allegations and directs the licensee (Respondent) to file a written Answer to those allegations within 30 days.
What is disciplinary action?
Disciplinary actions are a matter of public record and are subject to release by the Department of State's Office of Communications and Press to various news agencies in the Commonwealth.
How many professional and occupational licensing boards are there in Pennsylvania?
The Pennsylvania Department of State receives complaints concerning the licensees and registrants of the following 29 professional and occupational licensing boards & commissions regulated by the Department's Bureau of Professional and Occupational Affairs.
Can disciplinary action be filed against a licensee?
Decisions about whether or not to prosecute cases are constrained by the applicable licensing laws, rules and regulations, which set forth specifically enumerated offenses for which the licensing boards and commissions may impose discipline on a licensee. If offensive conduct or activity does not fit within any specifically enumerated offense, disciplinary action cannot be filed against the licensee because the activity is not within the applicable board or commission's jurisdiction