 |
 |
 |
 |
 |
 |
HOME ► Medicare Beneficiaries ► Your Quality of Care Concerns
Your Quality of Care Concerns
| What should you do if you have a concern about, or are not satisfied with the quality of care you received? 1. Call HealthInsight at 1-800-748-6773 and describe your concern. One of our trained team members will listen and help you decide what to do. One of your choices is to make a formal complaint. 2. If you decide you want to make a formal complaint, we can help you put it in writing. Once HealthInsight receives the written complaint, the quality of care review will begin. Click here to obtain a copy of the complaint form. Your case may be suitable for mediation, a new alternative to resolve your concerns by talking directly with your doctor. (Learn more) This is a free service for Medicare members. |
Examples
|
Who conducts the review and what
does it include?
HealthInsight works with a panel of physician reviewers to address quality of care concerns.
A nurse reviewer from HealthInsight will contact you once the completed written complaint is
received and serve as your point of contact throughout the review process.
The physician reviewer looks at all aspects of care surrounding your
complaint, and makes an initial finding that is shared with the healthcare provider or facility your
complaint is related to. Your healthcare provider/facility also has
the opportunity to comment. HealthInsight works directly with you and
your provider to resolve
the problem and make sure that you and other Medicare members receive
the best care possible.
Please be aware that the entire medical record review process can take
anywhere from three to six months.
If you are concerned about the quality of care you received
in Nevada or Utah
To request a review or to file a complaint about the quality of care
you received in Nevada or Utah, please call 1-800-748-6773.
If you are concerned about the quality of care you received
in another state
Each state has a quality improvement organization like HealthInsight. To request a review or
file a complaint about the quality of care in a state outside Nevada or Utah, please
call 1-800-Medicare (1-800-633-4227) to obtain the phone number for the quality improvement organization in that state.
How and when to contact us
Our office is open Monday through Friday, 8:00 a.m. to 4:30 p.m. (Pacific
Time). You may, however, leave a message on our toll free number
at 1-800-748-6773 any time including weekends.
Call HealthInsight if:
- You wish to discuss the quality of care you received.
- You want to file a formal quality of care complaint.
- You need help understanding your Medicare rights.
Call 1-800-MEDICARE (1-800-633-4227)
if:
- You have general questions about Medicare coverage.
- You need clarification on how to enroll in Medicare.
- You wish to discuss billing issues.
- You want to learn more about Medicare benefits and services.
You can also visit www.medicare.gov for general information on Medicare.
