Health Insurance Complaints?
The Department of Insurance Needs to Know
If you think a health insurance company is in violation of the Network Adequacy and Transparency Act, the Prior Authorization Reform Act or any other law or regulation, please file a complaint with the Illinois Department of Insurance (DOI). Taking such action is an important step against wrongful health insurance company practices.
When appropriate, encourage your patients to file complaints also, using the same portal on the DOI website.
Need help? Contact the DOI’s Office of Consumer Health Insurance toll free at 877-527-9431.
The Illinois State Medical Society is tireless in its advocacy to protect physicians and patients from unfair, onerous, and unnecessary requirements imposed by health insurance companies that can limit access to timely and necessary care. In the past couple of years, ISMS has worked with legislators in Springfield to pass two significant and comprehensive laws that require insurance companies to be more accountable to patients and physicians – the Network Adequacy and Transparency Act (NAT Act), which helps ensure patients have convenient access to physicians and health care facilities that are in network with their insurance plan, and the Prior Authorization Reform Act, which increases transparency of the prior authorization (PA) process, and requires insurers to provide timely determinations based on evidence based criteria.
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