Sida loo gudbisto cabasho
If you'd like to make a complaint or file an appeal about a claim that was denied, call customer service at the number on the back of your member ID card. Haddii aadan awoodin inaad xalliso cabashadaada, waxaad xareyn kartaa racfaan. Start by downloading the complaint/appeal form for your health plan. Foomamka waxa laga heli karaa xagga hoose ee boggan.
Dib u eegida dacwad ama racfaan
Haddii aadan ku qanacsanayn natiijada cabashadaada ama racfaankaaga, waxaad codsan kartaa dib u eegis madax banaan. Ka eeg tabka "Weydiiso dib u eegis" macluumaad dheeraad ah.
Cabashooyinka ku saabsan ilaalinta gaarka ah
Haddii aad cabasho ka qabto dhaqamadayada sirta ah ama aad dareentid inaan aannan u hoggaansamin shuruudaha Ogeysiiska Dhaqanka Qarsoonnimada, waxaad xaq u leedahay inaad gudbiso cabasho. Waxaad soo dejisan kartaa foomka hoose.
Macluumaad dheeraad ah iyo foomamka
Haddii aadan hubin midka loogu talagalay qorshahaaga caafimaad, wac lambarka ku yaal dhabarka dambe ee kaarka aqoonsiga xubintaada.
- Cabashada Medicare iyo macluumaadka racfaanka
- Blue Plus fully insured complaint/appeal form (PDF)
- Blue Cross fully insured complaint/appeal form (PDF)
- Blue Cross self-insured complaint/appeal form (PDF)
- Qoysaska Blue Advantage iyo Carruurta/Foomka Xuquuqda rafcaanka ee MinnesotaCare (PDF)
- SecureBlue (HMO SNP) cabashooyinka/qaabka racfaanka (PDF)
- Foomka cabashada ku dhaqanka asturnaanta (PDF)
- Non-Minnesota / non-par provider claim adjustment / appeal form (PDF)
- Hel Acrobat Reader
Sida loo codsado dib u eegis madax banaan
If you are unhappy with a decision we've made about your complaint or appeal, you may ask for additional information or explanation by calling customer service at the number listed on the back of your member ID card. Haddii cabashadaada ama rafcaankaagu ay ku saabsan tahay adeegga daryeelka caafimaadka ama sheegasho ama heshiis ka noqosho, dib u eegista urur madax banaan ayaa laga yaabaa inay diyaar kuu noqoto.
Muhiim:
Inta badan, waa inaad marka hore bogtaa nidaamka rafcaanka gudaha. Qorshayaasha uu maamulo Gobolka MN waxay leeyihiin kharash xarayn ah oo dhan 25, taas oo uu gobolku ka tanaasuli karo hadii ay jirto xaaladaha dhaqaale xumo. Tilmaamaha dib u eegista madaxa banaan ma khuseeyaan dhammaan qorshayaasha ama cabashooyinka/rafcaannada. Si aad u ogaato haddii aad haysato ikhtiyaarka dib u eegis madax banaan wac lambarka adeegga macmiilka ee ku yaal dhabarka kaarkaaga aqoonsiga ee xubinta ama dib u eeg nuqul ka mid ah shahaadada caymiskaaga si aad u aragto fursadaha racfaanka.
Sida loo codsado dib u eegis
Si aad u codsato dib u eegis, fadlan tixraac tilmaamaha ku jira warqadaada diidmada ee nidaamka racfaanka ama la xidhiidh xafiiska ku haboon ee hoos ku xusan. Urur dib u eegis madax banaan ayaa kula shaqayn doona adiga iyo qorshahaaga caafimaad si ay dib ugu eegaan sheegashadaada. Waxa kale oo aad dooran kartaa qof ku matalo adiga, laakiin waa in aad taas qoraal ku weydiisataa.
Su'aalo?
Haddii aad leedahay qorshe caymis buuxa ama qorshe gobolku nidaamiyey, oo aad hayso su'aalo ku saabsan dib u eegista, la xidhiidh mid ka mid ah xafiisyada soo socda:
- Waaxda Ganacsiga ee Minnesota - 1-800-657-3602 (Blue Cross and Blue Shield of MN plan)
- Waaxda Ganacsiga ee Minnesota - 1-800-657-3916 (Blue Plus of MN plan)
- Haddii aad leedahay Qorshe Goboleed Badan, Xafiiska Maraykanka ee Maaraynta Shaqaalaha - 1-855-318-0714(Blue Cross and Blue Shield) Qorshaha MN)
Haddii aad leedahay qorsha is caymis ah ama aadan hubin nooca qorshaha aad leedahay, wac lambarka adeegga macmiilka ee ku yaal dhabarka kaarkaaga aqoonsiga ee xubinimada.
Don't have a copy of your certificate of coverage?
Call customer service at the number on the back of your member ID card to ask for a copy.