Through the Division of Member Advocacy, the Illinois State Medical Society (ISMS) assists ISMS members who experience difficulties or hassles with the policies or procedures of various government agencies and third party payors including Medicaid, Medicare, Blue Cross Blue Shield of Illinois, HMOs, PPOs, IPAs, etc.

Information provided in this form will facilitate the ISMS Division of Member Advocacy in tracking, monitoring and resolving the issues presented. Please be aware that data provided may be shared with specific payors, state agencies or internal ISMS councils in order to address, track, and resolve problems. Upon submission of this data, an ISMS Advocacy representative will contact you to discuss resolution of your concern.

Please choose one of the following:

• PDF file
  
  Once the log is downloaded, it may be printed and sent to us by mail or fax.

• Receive form by fax or mail
  
  ISMS members can also request an ISMS Hassle Factor Log sent to them via fax or mail by contacting the ISMS Division of Member Advocacy at 800-782-ISMS or e-mail advocacy@isms.org.