We collected information about Provider Complaints for you. There are links where you can find everything you need to know about Provider Complaints.
https://www.healthgrades.com/
Use of this website and any information contained herein is governed by the Healthgrades User Agreement. The content on Healthgrades does not provide medical advice. Always consult a medical provider for diagnosis and treatment.3.9/5(959)
https://www.medicare.gov/claims-appeals/how-to-file-a-complaint-grievance
Find out how to file a complaint (also called a "grievance") if you have a concern about the quality of care or other services you get from a Medicare provider. Contact your State Health Insurance Assistance Program (SHIP) for local, personalized Medicare counseling.
https://www.tn.gov/commerce/tenncare-oversight/mco-dispute-resolution/provider-complaint-process.html
Always include with your provider complaint: Full name of provider contact person. Mailing address. Phone #. Fax number #. Email address.
https://hhs.texas.gov/about-hhs/your-rights/complaint-incident-intake/how-do-i-make-a-complaint-about-hhs-service-provider
If you think a provider that is licensed or certified by Texas Health and Human Services has broken the rules, let us know. Complaints can come from anyone — the person affected, family members, health care providers, advocates, police or other state agencies. You can make a complaint over the phone, by email or in writing.
http://www.aetna.com/healthcare-professionals/documents-forms/provider-complaint-appeal-request.pdf
Provider Name . TIN/NPI . Provider Group (if applicable) Contact Name and Title . Contact Address (Where appeal/complaint resolution should be sent) Contact Phone . Contact Fax . Contact Email Address . To help Aetna review and respond to your request, please provide the following information. (This information may be found on correspondence from Aetna.)
https://providercomplaints.ohiomh.com/
HIPAA Guidelines for Provider Complaint Attachments Your submission must only include information for Medicaid members. Including personal information for non-Medicaid members is a HIPAA violation.
http://www.dmhc.ca.gov/FileaComplaint/ProviderComplaintAgainstaPlan/SubmitaProviderComplaint.aspx
Submit a provider complaint Submit a Provider Complaint The DMHC recognizes that it is important for hospitals, doctors and other providers to be paid promptly and accurately, and our Provider Complaint process is offered as a means of ensuring prompt payment. Before You Submit a Complaint
https://www.dmhc.ca.gov/FileaComplaint/ProviderComplaintAgainstaPlan.aspx
Provider Complaint Against a Plan Submit a Provider Complaint The DMHC recognizes that it is important for hospitals, doctors and other providers to be paid promptly and accurately, and our Provider Complaint process is offered as a means of ensuring prompt payment.
Vitals Consumer Services, LLC ("Vitals"). the provider of this website, does not recommend or endorse any particular healthcare provider whose information or ratings appear on this website; and (2) Vitals has granted you a limited license to access and use this website for your own noncommercial use.
https://www.illinois.gov/hfs/MedicalProviders/cc/Pages/ManagedCareComplaints.aspx
The provider portal was created for providers to submit complaints to HFS about issues you are experiencing with Illinois Medicaid Managed Care Organizations (MCOs) in an electronic and secure format. Our goal is to answer MCO-related questions promptly and ensure fair resolution of disputes involving MCOs and providers.
http://www.insurance.ca.gov/01-consumers/101-help/hcpcomplaints.cfm
The Health Care Provider complaints section is designed to assist with resolving complaints regarding improper denial or delay in payment of a claim, other claims handling issues, Dispute Resolution Mechanism difficulties, and misconduct of the health insurer.
https://dfs.ny.gov/complaint
If you are a health care provider, use our online Provider Complaint Application to file a complaint about prompt payment, no fault or workers compensation claims, or to …
https://medicaid.ohio.gov/Provider/ManagedCare/ProviderComplaint
> Provider Complaint Information for Providers Before Making a Complaint Providers are responsible for confirming the Medicaid eligibility and the Managed Care Plan (MCP) insurance coverage—or plan enrollment—of a patient.
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https://www11.anthem.com/provider/noapplication/f1/s0/t0/pw_e182206.pdf
Examples of provider complaints include but are not limited to: claims denied for untimely filing, Anthem contractual reimbursement (i.e. pricing), Anthem clinical claim edits (i.e. code bundling).
http://ahca.myflorida.com/Medicaid/complaints/
All complaints submitted to the Agency are: Prioritized – We work complaints based on the urgency of the reported issue, not the order received. For example, a complaint from someone who cannot pick up his medication at the pharmacy is worked before a complaint about an unpaid medical bill.
https://providers.amerigroup.com/ProviderDocuments/TXTX_CAID_ComplaintsAppeals_ENG.pdf
Amerigroup provider manual. Provider complaints Amerigroup accepts provider complaints verbally, by mail, fax and email. Verbal complaints may be submitted through Provider Services at 1-800-454-3730 or through local Provider Relations representatives. Written provider complaints should be mailed to the following address: Amerigroup P.O. Box 61789
http://ahca.myflorida.com/Medicaid/complaints/complaints_provider.shtml
All plans have a provider complaint system to allow providers to dispute plan policies, procedures, or any aspect of a plan’s administrative functions, including proposed actions, claims/billing disputes, and service authorizations. Plans must maintain a complete and accurate record of all complaints and share this information with Agency.
https://www.health.state.mn.us/facilities/regulation/directory/provcompselect.html
Search for Minnesota Health Care Provider Complaints. Search Tips. You must enter information in each of the five steps. If you're unsure of what you are looking for, select the "all" categories. To find all the investigations for a facility, you must do three searches. One search for each finding type (substantiated, unsubstantiated, and ...
https://www.superiorhealthplan.com/providers/resources/complaint-procedures.html
For help filing a provider complaint or to check on the status of a provider complaint, providers may email [email protected]. When a complaint is received, a written acknowledgement letter is sent to the provider within five (5) business days of receipt of the complaint.
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