What if I have questions about a bill I received from a medical provider?
What if I have questions about a bill I received from a medical provider?
If you have questions about a medical bill or the services you received from a healthcare provider, it’ s important to know who to ask for help. Reaching out to the right person or group can make it easier and faster to solve your problem. Usually, you should ask the group responsible for the issue, whether it’ s Senior Care Plus or your doctor.
WHEN TO CONTACT SENIOR CARE PLUS You should call Senior Care Plus if your questions are about:
• Plan benefits, like your copays
• Denied Payment or Authorization of Services
• An Explanation of Benefits you received from Senior Care Plus
• Problems finding in-network providers or services
• Unresolved issues with your provider
• Rules or policies of your health plan
WHEN TO CONTACT YOUR PROVIDER
If your concerns are about the care you received or a bill you received from your provider, contact your provider’ s office. This includes:
• Questions about charges or a bill
• Concerns about staff behavior
• Difficulty getting information about your health
• Concerns about care, like scheduling or cleanliness
• Immediate health or safety issues
IF YOU’ RE CALLING TO SUBMIT A COMPLAINT
• Your Customer Service representative will explain what to expect during the complaint process.
• Don’ t hesitate to ask questions— such as when you can expect a resolution or how long you have to file your complaint.
• See page 24 to better understand what to expect with the grievance process.
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