The medical system can deliver amazing care to patients, with results that sometimes seem miraculous. Most consumers receive appropriate care — with good results — and are treated respectfully by doctors, nurses and other medical personnel, as well by employees of health insurance companies handling the bills.
But sometimes the care and treatment and conduct of personnel does not meet professional standards. If you or a loved one experience e a problem with a medical provider or an insurer, you have several options. The first, of course, is discussing the issue with the doctor, nurse, supervisor or designated representative of your health care provider or insurance plan. Another option is filing a complaint with a regulatory agency. Her are some resources if airing your complaint doesn’t get satisfactory results.
Insurance plans:
You can start with the plan itself or go through your employer if your coverage is a benefit of your job. The Georgia Insurance Commissioner’s office also has a Consumer Services Division (Phone: 404-656-2070). But if you work for a large employer with a self-insured plan, the insurance commissioner’s staff won’t be able to help much because the state lacks regulatory authority over self-insured health plans. Still, there is an option to appeal decisions by your health plan through the plan’s own appeal process. Consumers sometimes can get good results by filing an appeal — and being persistent through that process.