|QIO Program Changes|
|HSAG will soon be handing over quality-of-care, appeal, and review services that it conducts for Medicare beneficiaries to new organizations. |
Complaints Your Quality-of-Care Concerns
If a Medicare beneficiary has a concern or is not satisfied with the quality of care received, he or she can call the HSAG California Medicare Beneficiary Complaints Helpline at1-866-800-8749
. A beneficiary may also download a Quality-of-Care Complaint Form (English
) to complete and fax to 813-354-0737 or mail to:
Attention: Medicare Quality of Care Beneficiary Complaints
Health Services Advisory Group
5201 West Kennedy Boulevard
Tampa, Florida 33609
Examples of Poor Quality Care:
- Receiving the wrong medication
- Receiving unnecessary surgery/diagnostic testing
- Receiving an overdose of medication
- Experiencing a delay in service
- Receiving inadequate care or treatment by any Medicare hospital or doctor
- Experiencing a change in condition that was not treated
- Receiving a misdiagnosis
- Receiving inadequate discharge instructions
One of HSAG's trained team members will listen to the complaint and help the beneficiary decide what to do. One of a beneficiary's choices is to make a formal complaint. If the beneficiary decides to make a formal complaint, an HSAG team member can help put it in writing. Once HSAG receives the written complaint, the quality-of-care review will begin.
A beneficiary may also directly submit their complaint electronically by clicking HERE
. Please be advised that when submitting a complaint electronically, the QIO cannot be held responsible for the privacy and security of the beneficiary’s protected health information (PHI) during its transmission.
One of our trained team members will review the complaint and help the beneficiary decide what to do. The case may be suitable for Immediate Advocacy, a new alternative to resolve concerns through HSAG of California talking directly with a beneficiary's provider. Immediate Advocacy is an informal process used to quickly resolve an oral complaint. The use of Immediate Advocacy is not appropriate for situations where the beneficiary does not want his or her identity disclosed to the provider and/or practitioner.
How and When to Contact HSAG
Trained team members are available Monday through Friday from 8:00 a.m. to 4:30 p.m. However, a beneficiary can leave a message at HSAG's toll-free number, 866-800-8749
, 24 hours a day, seven days a week. One of HSAG's team members will assist you with translation services if English is not your primary language.
A beneficiary can call HSAG at 866-800-8749
if he or she:
- Wishes to discuss the quality of care received.
- Wants to file a formal quality-of-care complaint.
- Needs help understanding Medicare rights
A beneficiary can call 1-800-MEDICARE if he or she:
- Has general questions about Medicare coverage.
- Needs clarification on how to enroll in Medicare.
- Wishes to discuss billing issues.
- Wants to learn more about Medicare benefits and services.