My Patient Rights.org (mypatientrights.org) is a website inspired by actual patients who have experienced denials, delays, high out-of-pocket costs, out-of-network charges and other barriers to quality, affordable health care. The website can help patients with M.E.
STEP ONE-Notify Your Health Plan-file a formal complaint with your health plan.
Here is an outline of the health plan review process and timelines:
*Filing a formal complaint over phone, letter, email or online through your health plan's website.
*If you disagree with your Health Plan's decision, you have the right to file an appeal within 180 days.
*A physician not involved in the original denial of care must review your appeal of denial. You must receive a decision in writing or electronically within 30 days.
*A second review is required if your first appeal is denied-with a meeting scheduled within 60 days. Your health plan must give a decision 7 days after that.
*Regulators allow an external appeal if the health plan denies your appeal a second time. The health plan must make a decision on external appeals within 45 days of the request's filing.
(Links to complaint forms for Colorado's top health plans are listed on the website)
STEP TWO-File a Complaint
You have the right to file a complaint with the Colorado Division of Insurance (DOI) if you have a problem getting the services you need, including quality and affordable health care. To file a complaint, you must first file an appeal with your health plan.
*File a complaint with the DOI
*Call the DOI helpline (800)930-3745
***The Chronic Care Collaborative-main purpose is to advocate, inform, and educate regarding health policy issues that affect people living with a chronic disease.
In addition to filing a complaint with the Colorado Division of Insurance, we encourage you to share your story (mypatientrights.org). Sharing your story will help highlight recurring health care barriers that place other patients like you at risk. Both actions will help the CCC advocate to improve access to health care for all people in Colorado, especially the one in four Coloradans living with a chronic condition.
MEAction CO will help people through the process if they need. Contact Pam Lutey at firstname.lastname@example.org. She will research your request and try to help.