Medical Complaint Resolution
To resolve problems with a medical insurance company:
If you are a patient with concerns about delayed insurance reimbursement, payments or issues regarding covered benefits, which are not related to the satisfaction of medical care that was received from a doctor or health provider, then your complaint should be directed first to the insurance carrier. Many insurance companies also have Provider Relations or Customer Service departments to help settle disputes. Telephone numbers are usually located on the back of your insurance card. If you get no satisfaction and still feel your complaint is legitimate, then contact the:
Colorado Department of Regulatory Agencies
To resolve problems with a hospital:
Most hospitals have patient representatives which should be your first contact when trying to resolve problems which are related to satisfaction with health care received at a hospital or medical care facility. If the problem cannot be resolved at that level, contact the Colorado Department of Public Health and Environment at http://www.colorado.gov/cs/Satellite/CDPHE-HF/CBON/1251590617775 (303) 692-2827.
To resolve problems regarding an individual physician's care:
If the physician is a member of the Denver Medical Society, the society's Patient and Physician Relations Committee (PPR) will look into any patient's complaint if it is within its jurisdiction. Click here, Physician Finder, to verify membership. You are encouraged to try to resolve the problem directly with the doctor or his or her staff. If, after your best efforts, the problem is still not resolved to your satisfaction, you may file the complaint with the DMS grievance committee. All complaints must be in writing and faxed to (303) 331-9830 or mailed to:
Patient and Physician Relations Committee
The Patient and Physician Relations Committee cannot become involved in a mediation case if a patient retains legal counsel or if the complaint is being reviewed by the Colorado State Board of Medical Examiners.
The Colorado State Board of Medical Examiners is responsible for licensing Colorado physicians. All patients have the right to file a complaint with the State Board. They can be contacted at:
State Board of Medical Examiners
Denver Medical Society 1850 Williams Street Denver,