| If you have experienced a problem
with your Managed Care Health Insurance Plan (MCHIP), or if
you have a question regarding your MCHIP, you should first contact
your MCHIP for assistance. Contact information is provided on
your insurance card and also in documents the MCHIP provides
to you such as the evidence of coverage. Usually the MCHIP can
answer your question. If you do not understand your MCHIP's
response, disagree, still have questions or are uncertain about
something, contact this office for help.
If you have an informal question or concern,
you can contact us for assistance by calling toll-free 877-310-6560
or if you're in the Richmond metropolitan area you can contact
us at 804-371-9032. You can also write to us at Office of the
Managed Care Ombudsman, Bureau of Insurance, P.O. Box 1157,
Richmond, VA 23218. Our fax number is 804-371-9944. You can
also contact us via electronic mail at ombudsman@scc.virginia.gov
We will respond to your question or concern related to your
MCHIP or to managed care.
If you would like this office to formally
assist you appeal an adverse decision that your Managed Care
Health Insurance Plan (MCHIP) has made, then please complete
an Inquiry Form which you can download from this page. You will
have to download the form and send it to us, because at this
time we can not receive the form electronically. When you return
the form, please include copies of any denial letters you have
received from your MCHIP. This office will then assist you in
the appeals process, and make sure that you understand your
rights. If necessary, we will contact your MCHIP to clarify
any issues related to your appeal that are not clear or that
are in dispute. |
