If you are a Medicare beneficiary residing in New York State and you have concerns about the quality of health care you have received, there is a place that will review your concerns and work with your health care providers to improve care for future patients. Call IPRO at 1-866-391-4682 if you have a complaint about the quality of health care you received.
Some examples of quality of care concerns you might report include:
IPRO is the federally-funded Medicare Quality Improvement Organization for New York State and is under contract with the U.S. Centers for Medicare & Medicaid Services (CMS)-the part of the government that oversees Medicare-to improve the quality of care that Medicare patients receive in any health care setting.
Before calling IPRO, have the following information handy:
During this call, you will be asked questions that will allow IPRO to better understand your concerns. You will also be asked to send information about your concerns to IPRO in writing. If you cannot write your concerns, the review case manager dedicated to your case will help you write your letter. IPRO will then request a copy of your medical records from your health care provider.
IPRO uses impartial doctors to review information in your medical records and other correspondence about your concerns. These experts check to see if there were any quality problems, determine if the care given was necessary and if the right treatment was given. Since even good care or correct drugs can sometimes harm a patient, they also see if good judgment was used in deciding on your treatment and if risk to you could have been avoided.
A typical review takes about three months to complete. The review case manager dedicated to you will keep you updated on the progress of your case from start to finish.
At the end of the review, IPRO can tell you whether your care met approved standards. If your concerns are about your doctor, federal rules do not allow IPRO to tell you more without your doctor's consent. If your medical care did not meet approved standards, IPRO works with your health care provider to develop a
plan to improve care for future patients.
"...I was so fortunate for your...staff who were able to take on the system.... I will always remember your kindness in a maze of corporate red tape."
"Just want to say thank you for caring and being available momentarily by a direct phone line. My husband and I have not been defeated by all that we endured following the many complications I suffered, but thank you for identifying and helping us prevent it from happening to another individual."
"Thank you for calling the doctor's office on my behalf and relaying my complaints; maybe the doctor will listen to what I am complaining about now!"
We welcome your feedback/comments regarding all articles in this newsletter. Call IPRO's Quality of Care Concern Toll-Free Helpline 1-866-391-4682 www.YourHealthYourVoice.org