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How does a provider file a HMO complaint?

When submitting a complaint please include your contact information, the enrollee's name, member ID number and date of birth, the HMO's name and the reason for the complaint. Be specific when explaining the reason for your complaint and include any supporting documentation.

If the complaint involves a claim issue, please submit a copy of the claim form (CMS1500, UB04 or ADA), evidence of your collection attempts, evidence of timely claim filing, and if applicable the date your contract was last renewed with the HMO.

Providing this information will help the department during the investigation of your complaint.

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Last updated: 09/06/2014

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