Consumers

Medicare Beneficiary Complaint Response Program

As part of its contract with Medicare, Qualidigm offers a Beneficiary Complaint Response Program - free of charge - to empower Medicare beneficiaries to get the most out of their Medicare benefits and to fully understand the care they receive.

Process

• Beneficiaries (or their caregivers) who have a concern, or who are not satisfied with the medical care they receive, can file a complaint or inquiry with Qualidigm by calling 1.800.553.7590.
• One of two things will happen:
  • Medical record review will be used to determine whether standard guidelines or expected practices were followed by the health care provider.
  • Mediation may be offered if the complaint meets certain guidelines.