As a Quality Improvement Organization, we are responsible for reviewing written quality of care complaints lodged by Medicare beneficiaries, regardless of whether they’re a member of Original Medicare or are enrolled in a Medicare Advantage plan.
These reviews can involve determinations of whether care was reasonable and medically necessary, met professionally recognized standards of health care, or was provided in the appropriate setting.
Complaints can concern care received in the following settings:
Read the how to file page to learn about the types of reviews we conduct as well as how to submit a complaint.
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