If your health plan is a "managed care plan", you may have certain rights under Act 68.Please Read Carefully:Filing a complaint with the Attorney General may not preserve your appeal rights, pursuant to ACT 68. To preserve your rights, you must file a complaint or grievance appeal directly with your health plan or in conformance with the terms of your coverage. The Office of Attorney General does not give legal advice.If you have a problem with your HMO or Point of Service plan, you should"Take the Proper Steps", as follows:
Grievance - for example, denial of payment for a health care service.
Complaint - for example, a problem with a provider or the coverage operations or management policies of the health plan only.Please note: There may be different procedures for handling complaints and grievances for the following:
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