PPO II - EmblemHealth

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2013 Evidence of Coverage for PPO II) II Chapter 2: Important phone numbers and resources How to contact us when you are making an appeal about your medical care An appeal is a formal way of asking us to review and change a coverage decision we have made. For more information on making an appeal about your medical care, see Chapter 9 (What to do if you have a problem or complaint (coverage decisions, appeals, complaints)). Appeals for Medical Care CALL 1-866-557-7300 Calls to this number are free. Monday – Sunday 8:00 am to 8:00 pm For expedited appeals: 1-888-906-7668 TTY 1-866-248-0640 Thi s number requires special telephone equipment and is only for people who have diffi culties with hearing or speaking. Calls to this number are free. Monday – Sunday 8:00 am to 8:00 pm For expedited appeals: 1-866-248-0640 FAX 1-212-510-5320 For expedited appeals: 1-212-287-2754 WRITE EmblemHealth Medicare PPO ATTN: Grievance and Appeals PO Box 2807 New York, NY 10116-2807 WEBSITE www.emblemhealth.com/medicare 17
18 2013 Evidence of Coverage for PPO II Chapter 2: Important phone numbers and resources How to contact us when you are making a complaint about your medical care You can make a complaint about us or one of our network providers, including a complaint about the quality of your care. Th is type of complaint does not involve coverage or payment disputes. (If you have a problem about the plan’s coverage or payment, you should look at the section above about making an appeal.) For more information on making a complaint about your medical care, see Chapter 9 (What to do if you have a problem or complaint (coverage decisions, appeals, complaints)). Complaints about Medical Care CALL 1-866-557-7300 Calls to this number are free. TTY 1-866-248-0640 Monday – Sunday 8:00 am to 8:00 pm This number requires special telephone equipment and is only for people who have diffi culties with hearing or speaking. Calls to this number are free. FAX 1-212-510-5320 Monday - Sunday 8:00 am to 8:00 pm WRITE EmblemHealth Medicare PPO ATTN: Grievance and Appeals PO Box 2807 New York, NY 10116-2807 MEDICARE WEBSITE You can submit a complaint about our plan directly to Medicare. To submit an online complaint to Medicare go to www.medicare.gov/MedicareComplaintForm/home.aspx.
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104 • Chapter 5 of this booklet.
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PPO II - EmblemHealth

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