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Medicare Complaint vs Quality of Care

Disclaimer: We are not attorneys and cannot act as your legal representative. However, we can determine whether the company or agent is following insurance laws and your policy. Results vary from explaining a situation to getting a claim paid.

What is a Medicare complaint?

You are seeking assistance with a problem due to:
  • claims not being paid
  • billing issues
  • problems with your insurance company/agent
  • possible fraud/scam situation you feel has taken place
  • denial of coverage
  • or another issue that is just difficult for you to handle on your own pertaining to Medicare

 

What is quality of care?

A quality of care complaint or concern may refer to:

  • your health care/lack of health care you feel you might have received
  • receiving the wrong medication (you might be allergic or it interacts in a negative way)
  • developing an infection that was not treated correctly
  • not being taken care of in a timely manner
  • bill for a service you never received
  • developing bed sores because you weren’t moved regularly
  • not being treated with respect and listened to regarding your concern

For issues with a quality of care concern go to www.keproqio.com or call the helpline at 1-888-305-6759.

Kepro Corporate Office
5700 Lombardo Center Dr.
Suite 100
Seven Hills, OH 44131

If you have a Provider concern or complaint you can always call 1-800-Medicare (24 hours a day, seven days a week)

If you have a suspicion that you were a target of fraud or abuse call the SMP (Senior Medicare Patrol) or SHIBA at 1-800-247-4422.
Remember you can protect yourself against some targets by simply:

  • Never giving your Medicare/Medicaid number to strangers or anyone offering “free” service
  • Never accept medical supplies/equipment from a door-to-door salesperson
  • Always call your provider if you need clarification of questionable charges
ver: 3.5.2a | last updated: