Recipients
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Wisconsin
BadgerCare Plus or Medicaid SSI HMO
Ombuds
Working together...
for a healthier you
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BadgerCare Plus or
Medicaid SSI HMO Programs |
Welcome to the BadgerCare Plus or Medicaid SSI HMO Program
By now you have chosen your BadgerCare Plus or Medicaid SSI HMO and primary
doctor. We hope you are happy with the care you are receiving.
But what if you have problems or questions about the quality of care you and
your family are getting? Who do you talk to? What can be done? When can you get
help? How do you get help?
The Ombuds will answer your questions and look into your complaints about
access to good medical care. Call or write them today.
Who are the Ombudsmen?
If you have questions or concerns about your Wisconsin BadgerCare Plus or
Medicaid SSI Health Maintenance Organization (HMO), the Ombudsmen
(pronounced “Om-budz-men”) or Ombuds may be able to help you.
What do the Ombuds do?
- Research and resolve enrollee grievances about the care or services
provided by BadgerCare Plus or Medicaid SSI HMOs.
- Help BadgerCare Plus or Medicaid SSI HMO enrollees with grievances,
whether informal (telephone calls) or formal (written).
- Help BadgerCare Plus or Medicaid SSI HMO enrollees understand their
rights and responsibilities.
- Represent enrollee rights with BadgerCare Plus or Medicaid SSI HMOs.
- Act as a fair and impartial go-between.
When would you contact the
Ombuds?
As a BadgerCare Plus or Medicaid SSI HMO enrollee, you may call the
Ombuds anytime during your HMO enrollment.
Why would you call the Ombuds?
- Your BadgerCare Plus or Medicaid SSI HMO is billing you for services
during the time of enrollment.
- You are unsure of your rights as an enrollee.
- You are unable to get a BadgerCare Plus or Medicaid SSI-covered service
from your HMO.
- Your HMO has denied, reduced, or stopped BadgerCare Plus or Medicaid SSI-covered
services.
- You feel you were treated unfairly or disrespectfully.
BadgerCare Plus or Medicaid SSI HMO enrollees have the right to:
- Voice complaints.
- Be treated with respect and dignity.
- Be treated fairly and impartially.
- Receive interpreter services during the grievance process.
How do you file a grievance?
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Remember: Your health
care benefits will not be affected because you file a grievance.
All information will be kept confidential. |
Contact BadgerCare Plus or
Medicaid SSI Ombuds
Call Monday through Friday
8 a.m. to 4:30 p.m.
1-800-760-0001 (TTY and translation services available)
Write
BadgerCare Plus or Medicaid SSI HMO Ombudsmen
P.O. Box 6470
Madison, WI 53716-0470 Working together for a healthier you.
(Ombuds brochure) — PDF
Learn about PDF files Wisconsin Department of Health and Family
Services
Division of Health Care Access and
Accountability
Bureau of Managed Health Care Programs
PHC 12002 (02/08)
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