Make a Medicare Complaint
VHQC reviews complaints about the quality of medical care that was provided in any setting covered by Medicare, including inpatient hospitals, surgical centers, skilled nursing facilities, home health agencies, comprehensive outpatient rehabilitation facilities, emergency rooms, hospices, hospital outpatient areas, outpatient physical therapy and speech language pathology services, and physician offices.
Examples of medical quality complaints include: inappropriate diagnosis or treatment by any healthcare professional, wrong type or dose of medication, or wound care that was not provided.
VHQC cannot review complaints about issues that do not have a direct impact on medical quality; for example, complaints about food, patient rooms, or rude behavior by healthcare personnel. Our review is limited to what is documented in your medical record.
Before you make a quality of care complaint, it is important to understand the Medicare complaint review process. The benefits include:
- - Review of your medical record by a board-certified physician in an appropriate specialty
- - The opportunity, in some cases, for VHQC to assist you with alternate dispute resolution
- - The knowledge that you may be helping other patients, because quality complaints often identify issues that we can help healthcare providers prevent in the future
You should be aware that Medicare regulations state:
- - Complaints must be made in writing; VHQC can assist you
- - If you make an anonymous complaint, we will not be able to provide you with detailed review results
- - If your complaint is about a physician, he/she must agree to the release of detailed review results
- - Because it is a thorough process, our complaint review can take up to 165 days
