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Contact Your Plan

Unit 1 Consumer Health

If you are dissatisfied with your plan or any of its employees, providers, or contractors, or your plan´s services, determination of benefits, or the health care treatment received through the plan, you can file a complaint or grievance with your plan. You may make your complaint/grievance verbally or in writing. You may also designate someone to make the complaint/grievance for you.

Refer to your member handbook to learn how to use the plan´s complaint/grievance process or call the plan´s member services or complaint/grievance phone line listed on your health plan identification card. Managed care plans certified by the Department of Health must have a process to receive and respond to complaints and grievances. Many issues can be resolved with a phone call to your plan.

Contact Government Agencies

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Managed care enrollees and providers can file a complaint with certain government agencies. Depending on the type of health care plan involved and the kind of complaint, there are different agencies that can help. You do not have to file a complaint with your plan before you speak with or write to a government office.

The office you contact may ask you to complete a form to file your complaint. If you make a verbal complaint, you may be asked to send written information or documents to support your complaint. If you designate someone to make the complaint for you, you may be asked to sign a written authorization form to allow the government to share your personal health care information with your designee.

Once all needed information is received, the agency will review or investigate the complaint. The agency may work with the health care plan to correct the problem, and may check if any laws or regulations were violated. The agency will inform you of how the complaint was resolved.

To file a complaint, find your issue on the chart below and contact the government agency listed through the phone number, web site or mailing address provided.

Unit 1 Consumer Health
List of government agency complaint contacts
WhoIssueCallWrite
Anyone enrolled in a NYS certified MCO (not behavioral health services)
  • dissatisfaction with quality of health care
  • difficulty getting appointments
  • denied referrals
  • difficulty getting the health care or type of doctor needed
  • billing concerns or plan´s refusal to pay or a covered service
  • termination issues
  • delivery of medical care concerns
  • access and availability
1–800–206–8125 NYS Department of Health
Managed Care Complaint Unit
OHIP DHPCO 1CP–1609
Albany, New York 12237
Or Email: managedcarecomplaint@health.ny.gov
Anyone enrolled in a NYS certified MCO with questions or comments related to behavioral health managed care
  • Questions or complaints related to Mental Health programs or services
1–800–597–8481 NYS Department of Health
Email: NYSDOH.BCS.Behavioral.Health.Complaints@health.ny.gov
Anyone
  • cost of insurance policy
  • health care coverage questions
  • complaint against any insurance company
1–800–342–3736
New York City:
1–212–480–6400
Consumer Assistance Unit
NYS Department of Financial Services
One Commerce Plaza
Albany, NY 12210
Anyone
  • Consumer health–related complaints
  • Consumer health care rights
  • Fraudulent, misleading or deceptive practices
1–800–428–9071NYS Office of the Attorney General – Health Care Bureau
The Capitol
Albany, NY 12224-0341
Fax: (518) 650–9365
NY Medicaid managed care enrollee
  • eligibility questions
  • enrollment issues
Local Department of Social Services or
NY Health OPTIONS
1–855–693–6765
Local Department of Social Services
NY Medicaid managed care enrollee
  • Fair Hearing request
1–800–342–3334Fair Hearing Section
NYS Office of Temporary and Disability Assistance
Managed Care Hearing Unit
PO Box 22023
Albany, NY 12201–2023
Fax: (518) 473–6735
Anyone enrolled in a NY Managed Long Term Care
  • dissatisfaction with health care
  • difficulty getting health care needed
1–866–712–7197 NYS Department of Health
Bureau of Managed Long Term Care
Suite 1620, One Commerce Plaza
99 Washington Ave.
Albany, NY 12210
Anyone receiving services from a Workers´ Compensation PPO
  • dissatisfaction with the Workers´ Compensation PPO
1–518–474–5515 NYS Department of Health
Workers´ Compensation Programs
Room 1609, One Commerce Plaza
99 Washington Ave.
Albany, NY 12210
NY health care providers
  • late payments by a plan
  • prompt payment law
NYS Department of Financial ServicesNYS Department of Financial Services
One Commerce Plaza
Albany, NY 12210
Medicare recipients
  • dissatisfaction with quality of care in NYS
  • appeals and grievances
1–866–334–9866Centers for Medicare and Medicaid Services
Division of Medicare Health Plans Operations
26 Federal Plaza, Room 3810
New York, NY 10278
Anyone enrolled in a self–insured/ ERISA plan or through COBRA
  • Benefit claims
  • appeals information
1–866–444–3272

Eastern NY and NYC:

Button

Employee Benefits Security Administration
U.S. Department of Labor
New York Regional Office
33 Whitehall Street, Suite 1200
New York, NY 10004

Central and Western NY:

Employee Benefits Security Administration
U.S. Department of Labor
Boston Regional Office
J.F.K. Federal Building, Room 575
Boston, MA 02203

Baby Supplies You Need

As you begin to get ready for your baby to come home, there are a few essential items that you'll want to make sure you have. Many of these items can appear on your registry as baby shower gifts. Otherwise, you may want to purchase them at your convenience. The more you plan ahead, the more relaxed and ready you'll be when you bring your baby home.

Here is a list of items that you'll need:

Consumer Health Products

  • Sheets (3-4 sets). Flannel sheets are nice in the wintertime.
  • Mobile.
  • Noise machine.
  • There should be NO loose toys that can strangle the baby or pillows/soft bedding that can suffocate the baby. Do NOT install loose or fluffy bumper pads.
  • Make sure everything in the crib is age-appropriate.

Changing table supplies

  • Diapers -- plenty of them (8-10 per day).
  • Baby wipes -- unscented, alcohol free (don't get too many because some babies are sensitive to them).
  • Vaseline -- good to prevent diaper rash, and for boy's circumcision.
  • Cotton balls or gauze pads to apply Vaseline.
  • Diaper rash cream.

Rocking chair with a footstool

  • Pillow for resting arm when nursing.
  • 'Donut' pillow helps if you have a tear of the vagina or perineum (the space between the vagina and perineum) during delivery or if the area remains sore.
  • Blanket to put around you and baby when it's chilly.

Clothes for new baby

  • One-piece sleepers (4-6). Gown-types are easiest.
  • Mittens for their hands if they scratch their faces.
  • Socks or booties.
  • One-piece daytime outfits that snap (they are easiest and most functional).

General items

Unit 1 Consumer Health Answers

Unit 1 consumer health plan
  • Burp cloths (a dozen, at least).
  • Receiving blankets (4-6).
  • Hooded bath towel (2).
  • Wash clothes (4-6).
  • Bathtub -- one with a 'hammock' is easiest when they are tiny and slippery.
  • Baby wash.
  • Shampoo (baby safe).
  • Nursing pads and nursing bra.
  • Car seat -- most hospitals require that this be properly and securely installed before leaving hospital, so be sure to install it before picking the baby up.

Learn more about the babies from A.D.A.M.'s Pregnancy SmartSiteTM located within our SmartEngage product. In addition, the US Environmental Protection Agency website is a good source for ways to measure and mitigate radon in your home. If you have more questions Ask A Doctor. If you are interested in licensing our content, please contact us.

Unit 1 Consumer Health Insurance

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