You may find yourself in a situation in which you feel you have been wronged. When this happens, it is within your rights to file a formal complaint against the offending medical practitioner, hospital, health facility, or insurance company. Here are some steps to follow to file a complaint:
• Select the proper agency to complain to (accompanying list)
• Put your complaint in writing (see below for sample letter)
• Include the name of the offending party (doctor, hospital, etc.)
• Describe what your complaint is
• Tell where the incident occurred
• Give the date and time it occurred
• Include statements from witnesses, if any
• Include copies of bills and other related items
• Be willing and able to provide additional information if requested
Sample Complaint Letter
Dear (Commissioner/Secretary/Director/Chairperson):
I am writing to you to file a formal complaint against (name of person, institution, or organization) about an incident in which I believe I was wronged. I am requesting that an appropriate review and investigation be completed. I am prepared to provide the necessary documentation to support my complaint and to cooperate fully with the investigating officer assigned to my case.
I will briefly describe what happened and why I believe I am justified in filing this complaint. [Here, list exactly what happened.]
I will be waiting your reply and will complete any additional forms if necessary.
Your assistance in this matter is greatly appreciated.
Sincerely,
[Your Name]
Agencies that Handle Complaints
The following list outlines how to file a complaint based on whom or what the complaint is against. CCHCC has additional self-help packets for more assistance on how to file a complaint and additional information on the agencies listed below, including complaint forms and detailed descriptions of what each agency handles.
|
Complaint Against |
Where to File |
How to File |
|
Licensed Professionals |
Department of Financial andProfessional Regulation
*You can file a complaint by email. |
Phone: (312) 814-6910 100 West Randolph Street Chicago, IL 60601 http://www.idfpr.com
|
|
Health Maintenance Organizations(HMOs) |
1) HMO’s Complaint Procedure
2) If not satisfied, Illinois Department of Insurance |
Contact HMO for Complaint Procedure
Phone: (877) 527-9431 www.state.il.us/ins |
|
Health Care Facilities |
Office of Health Care Regulation |
Phone: (800) 252-4343 |
|
Insurance Companies |
1) Insurance Company’s ComplaintProcedure
2) If not satisfied, contact the ILDepartment of Insurance |
Contact Insurance Company forComplaint Procedure
Phone: (217) 782-7446 Consumer Complaints 320 West Washington Street Springfield, IL 62767 |
|
Quality of Care (i.e. patient rights,safety, care of patients) |
Joint Commission on Accreditation ofHealth Care Organizations |
Phone: (800) 994-6610 Fax: (630) 792-5636
Office of Quality Monitoring OneRenaissance Boulevard
|
|
Other (i.e. billing disputes,problems with access to care) |
Attorney General’s Health Care Bureau |
(877) 305-5145 TTY: (800) 964-3013 |