Otherwise, follow the links below for additional resources, or complete the Contact Us Form and we'll get back to you. Toni King is an author and columnist on Medicare and health insurance issues. If you file a complaint, our investigators don't share your name with the health care entity unless you instruct us otherwise. In some cases, the health care entity may be able to figure out your identity because of the nature of the complaint. Call Member Services at the number on the back of your ID card. She has spent nearly 30 years as a top sales leader in the field. You can send an internal health plan appeal in writing to: Superior HealthPlan If you are eligible for both Medicare and Medicaid and need to request an emergency appeal for Medicare acute care services, please follow the expedited review process for your Medicare Plan/Program. Medicaid Fraud Hotline 187787 FRAUD; Consumer. Complaint MyMedicare - Access to Your Personal Medicare Information, National Provider Identifier Standard (NPI), Clinical Laboratory Improvement Amendments (CLIA), Medicare Service Center: 800-MEDICARE (800-633-4227), Medicare Service Center TTY: 877-486-2048, Report Medicare Fraud & Abuse: 800-HHS-TIPS (1-800-447-8477), Toll-Free: 877-267-2323 (Employee directory available). You have the right to examine, at a reasonable time before the date of the Fair Hearing, the contents of your case file and any documents to be used by Superior at the hearing. Important telephone numbers for Texas Medicaid and CSHCN Services Program clients. You will receive a letter with the resolution to your complaint within three (3) business days. All rights reserved. When you call, we will ask for the following information: If you call after hours, our answering machine will take your message. You will be notified within five (5) business days that the complaint has been received. Web1-800-482-5431. You or your representative must ask for the External Medical Review within 120 days of the date Superior mails the letter with the internal appeal decision. If you have a Medicare Simply call Superior Member Services. After a Medicaid member has completed the internal health plan appeal process related to an adverse benefit determination, more appeal rights are available to a member if he/she is not satisfied with the health plans appeal decision. Ohio Interpreter services are provided free of charge, call Member Services for assistance. We accept complaints about fraud, waste and abuse in Medicare, Medicaid and other HHS Brookfield Counselor Sentenced to 30 Months in Federal Prison for A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. An expedited appeal is when Superior HealthPlan has to make a decision quickly based on the condition of your health, and taking the time for a standard appeal could jeopardize your life or health. WebFiling anonymously We accept anonymous complaints. 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An official website of the United States government They may call you to get more information, if needed.Researched We research your complaint. An official website of the United States government An External Review is an outside review of your health plans denial of a service you and your doctor feel is medically necessary. To check on the status of your benefits or application, call 2-1-1 or log-in to yourtexasbenefits.com. Expedited complaints concerning emergencies or denial of continued hospitalization will be resolved within one business day from receipt of the complaint or earlier depending on the medical immediacy of the case. This tool provides registered ASETT usersan additional level of security for filing complaints through Multi-Factor Authentication (MFA) and Remote IdentityProofing and allows attaching supportingdocumentation. Dissatisfaction with quality of care. WebMedicaid Program Important Phone Numbers Fraud. Medicaid members will have sixty (60) calendar days from the date of Superiors Notice of Adverse Benefit Determination letter to appeal the decision. * Indicates a required field Text must match the text in the above image. We will work on your problem until we find you an answer. 1-877-7SAFERX. When we hear about If more time is needed to gather facts about the requested service, you will receive a letter with the reason for the delay. You can call Member Services at 1-800-783-5386 with any questions. Complaints may be made by calling Superior Member Services at the number on the back of your ID card (Relay Texas 1-800-735-2989). File a Complaint | CMS - Centers for Medicare & Medicaid Michigan families urged to check air quality before participating in Medicare WebOffice of the Medicaid Inspector General: For suspected fraud, waste or abuse complaints/allegations, call 1-877-87FRAUD, (877) 873-7283, or visit Office of Medicaid Inspector General (OMIG) web site. This could be a doctor, relative, friend, lawyer, or any other person. WebNeed help beyond whats on Medicare.gov? If you have questions or concerns about someone living in a: Visit our Help Finding What You Are Looking For page where you'll find contact information for some of our most requested services including: Dialing 2-1-1 is a free, easy way to find out about services you can get in your area or through state programs. Vanessa Roberts Avery, United States Attorney for the District of Connecticut, announced that GREGORY C. BANKS, 50, of Brookfield, was sentenced today by U.S. District Judge Michael P. Shea in Hartford to 30 months of imprisonment, followed by three years of supervised release, for health care fraud. This organization is not related to your doctor or to Superior. How you file a complaint depends on what your If you received a secure email from our agencies, please read these instructions on how to open it. Web1800 132 468 if you need help with a complaint the National Relay Service if youre deaf, have hearing loss or have speech disability our free direct-call TTY service on 1800 810 586 one of our international phone numbers if youre overseas. Anyone can submit a. Medicaid Complaint. Austin, TX 78741 The KanCare Ombudsman office can help with: Answers to questions; Resolving issues; Medicaid Helpline 18005412831; Medicaid Managed Care. The improved Administrative Simplification Enforcement and Testing Tool (ASETT) isavailablefor use. SC DHHS ) You also can view a map in PDF format that shows these same regions along with the area agencies on aging and the local intellectual and developmental disability authorities. Before sharing sensitive information, make sure youre on an official government site. A Superior Member Advocate can help you with any questions you have about filing an appeal. Heres how you know. Toni King is an author and columnist on Medicare and health insurance issues. Texas Health and Human Services are headquartered in Austin, Texas. 1-866-539-7689. Summary of complaint and any associated documents to be sent via secure email. HHS will give you a final decision within 90 days from the date you asked for the State Fair Hearing. Attorney General Dana Nessel Charges Delta County Woman With If you do not request an External Medical Review within 10 days from the time you get the appeal decision from Superior, the service Superior denied will be stopped. Brookfield Counselor Sentenced to 30 Months in Federal Prison for You can ask to continue current authorized services when you appeal Superiors Adverse Benefit Determination. WebHOW TO SUBMIT A COMPLAINT. She has spent nearly 30 years as a top sales leader in the field. What you can expect from HHSC: Send you an acknowledgement letter within three to five business days. WebContact Us If you're a provider, call our Provider Hotline at 800-686-1516. You must complete the internal health plan appeal process through Superior HealthPlan prior to requesting a State Fair Hearing. Superior will send you a letter if a requested service that requires authorization is denied or limited. When we hear about problems, we investigate and respond quickly. TO FILE A COMPLAINT, PLEASE CHOOSE A CONTACT NUMBER BELOW: Health Standards Section complaints regarding service providers (Personal Care Attendant, Assisted Living, Respite Care, Family Support Services, Adult Day Health Care) 1-800-660-0488. June 28, 2023 LANSING Michigan Attorney General Dana Nessel has announced that Medicaid Fraud charges have been filed against Nicole Stouffer, 42, of Rock, Michigan. 1-800-843-6154
Please call 800-252-5400 or 9-1-1 if in immediate danger. *Days and hours may vary due to state holidays and inclement weather. For medical emergencies, please call 911. If you need help understanding the language being spoken, Superior has people who can help you on the phone or can go with you to a medical appointment. Contact CMS | CMS - Centers for Medicare & Medicaid Services WebMedicaid Director Office of Health Insurance Programs The Medicaid Update is a monthly publication of the New York State Department of Health Office of the Medicaid Inspector General: For suspected fraud, waste or abuse complaints/allegations, call 1-877-87FRAUD, (877) 873-7283, or visit Office of Medicaid Inspector General (OMIG) web site. 2023 AFMC Privacy | Disclaimers | Code of Conduct | Accessibility| Transparency in Coverage, Rural Communities Opioid Response Program, Substance Abuse Resource Assistance Coalition. Staff are available to help you Monday through Friday, 8:00am to 5:00pm EST. Complaint and Incident Intake800-458-9858. Medicaid Complaint Hotline | Help with Medicaid Service | AFMC Texas Health and Human Services (HHS) state office headquarters is located at:North Austin Complex4601 W. Guadalupe St.Austin, TX 78751-3146P.O. Important Telephone Numbers You can talk or live chat with a real person, 24 hours a day, 7 days week (except some federal holidays.) To file an Administrative Simplification HIPAA-related paper complaint rather than an electronic one, please complete this OMB-approved form 0938-0948 and Click here to learn about requesting records. If you do not request a State Fair Hearing by this date, the service the health plan denied will be stopped. Your appeal will be processed as a standard appeal with a response provided within 30 days. Written complaints can be sent on paper or electronically. Medicaid Program Important Phone Numbers - New York State or If you need help submitting a complaint, you can call our Medicaid Helpline at 1-877-254-1055 (TDD 1-866-467-4970). NYS Department of Health. Medicare The criminal complaint charges a total of 9 counts, all 4-year felonies. 7500 Security Boulevard, Baltimore, MD 21244, An official website of the United States government. Reporting Fraud File A Complaint ( The criminal complaint charges a total of 9 counts, all 4-year felonies. You can call Member Services at 1-800- 783-5386 (TTY: 1-800-735-2989) with any questions. WebWhen this happens, you may have the right to a Medicaid Fair Hearing. If You'd Like Assistance Reporting Suspected Fraud, the Senior Medicare Patrol (SMP) is Here to Help. Information in this page cannot respond to individual Medicare concerns. Instead, Kemp is limiting expanded coverage to adults earning up to 100% of the poverty line $14,580 for a single person or $30,000 for a family of four.