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COMPLAINTS BEING FILED BY PROVIDERS
This
page tells you how to file a complaint online. If you would prefer
to file your complaint by mail, click
here for instructions
for using our printed complaint forms.
This
page also has additional materials you may find useful including
a Patient Information Sheet that you can make available
in your office and a Medical Authorization
Form.
Instructions to File a Complaint Online
1. Gather any documents that are relevant to the complaint. Examples
include:
- a
copy of the claim your office submitted to the health insurance
carrier
- an
adverse coverage decision from the carrier;
- a
copy of the Medical Authorization Form signed by the patient
(if any);
- billing
statements; and,
- correspondence.
(You may need to refer to these documents while you are filling
out the complaint form and will need to send copies of these documents
to our office after you file your complaint.)
2. Mail in copies of the relevant documents along with a copy
of your Complaint Confirmation. Receipt of these forms is necessary to begin the mediation process.
3. Keep a copy of the complaint for your records.
Receipt of
the “Complaint Confirmation”, the Medical
Authorization Form and copies of other documents relevant to your
complaint are necessary to begin the mediation process.
To file your Complaint Online, Click
Here.
(If you are unable to download or print the complaint form, call
our office to have one mailed to you: 410-528-1840 or toll-free
in Maryland: 1-877-261-8807.)
Privacy Note: The information you submit will be used by the Attorney General staff in investigating your complaint. Medical or psychological information about an individual will not be disclosed to the public. To read our full privacy policy, click
here.
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