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Massachusetts Health Care Provider Complaint Form

Massachusetts Health Care Provider Complaint Form

Name: Massachusetts Health Care Provider Complaint Form
Brand: US Legal Forms
Price: 59.00 USD
Rating: 4.69 (482 reviews)

Category:

Massachusetts Workers Compensation - Official

State:

Massachusetts

Control #:

MA-SKU-1068

Format:

Instant download

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Public form

Description

Health Care Provider Complaint Form The Massachusetts Health Care Provider Complaint Form is a document used to file complaints against health care providers in the state of Massachusetts. It is a way to report misconduct, negligence, or violations of regulations or standards of care. It can be used to report any type of complaint, from substandard care to billing issues. The form includes sections to provide contact information, a detailed description of the complaint, and any additional information that may be helpful to the investigation. There are two types of Massachusetts Health Care Provider Complaint Forms. The first is the Complaint Against a Health Care Provider form, which is used to report complaints against a health care provider. The second is the Complaint Against a Health Care Facility form, which is used to report complaints against a health care facility, such as a hospital or clinic.

The Massachusetts Health Care Provider Complaint Form is a document used to file complaints against health care providers in the state of Massachusetts. It is a way to report misconduct, negligence, or violations of regulations or standards of care. It can be used to report any type of complaint, from substandard care to billing issues. The form includes sections to provide contact information, a detailed description of the complaint, and any additional information that may be helpful to the investigation. There are two types of Massachusetts Health Care Provider Complaint Forms. The first is the Complaint Against a Health Care Provider form, which is used to report complaints against a health care provider. The second is the Complaint Against a Health Care Facility form, which is used to report complaints against a health care facility, such as a hospital or clinic.

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How to fill out Massachusetts Health Care Provider Complaint Form?

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FAQ

If you are not able to provide a written complaint, you may call our 24 hour consumer complaint line at (800) 462-5540 or (617) 753-8150.

If you would like to submit a health care complaint by mail, please contact the Health Care Helpline at (888) 830-6277 for assistance.

How to file By mail + You can send your written complaint to the RMV at: Registry of Motor Vehicles. Driver Licensing Department. P.O. Box 55889. Boston, MA 02205-5889. By fax + You can fax your complaint to the RMV at (857) 368-0820. Online + You can email your complaint to the RMV at DriverEd.Registry@state.ma.us.

File a complaint with the OPP using the external review request form here. Call the OPP by phone: (800) 436-7757.

To report abuse of a person by nursing home or hospital, call the Department of Public Health at (800) 462-5540. Call 911 or local police if you have an emergency or life-threatening situation.

A. You can file a quality of care complaint to the Massachusetts Division of Healthcare Quality at 617-753-8150 or to the Joint Commission at 800-994-6610. If you think your civil rights have been violated, you can call the Massachusetts Attorney General's Office at 617-727-2200.

More info

You may also complete the form and click the submit button for the form to be automatically sent to the Central Complaint Registry email inbox. For non-long term care complaints contact the Department's Division of Health Care Facilities and Programs at 217-782-7412.Section I – Information ; This form is used to refer complaints about licensed medical care providers to the Program Integrity Unit. Providers are encouraged to try and resolve issues informally before initiating the formal provider claim dispute process. This form should be utilized if a claim has been processed and a Medicaid Remittance. Advice has been issued from Carolina Complete Health. For General Insurance Complaints (auto, health, home, life, long-term care, etc). Before the Ohio Department of Medicaid will process a complaint. If your complaint involves multiple MCOs, please complete one form per MCO. Click on the Complaint Intake Form link (below) which will direct you to a fillable PDF form.

Massachusetts Health Care Provider Complaint Form

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