Report a Problem
Is there a problem?
We hope our health plan serves you well. If you have a problem, you can call or write to Customer Care. Most problems can be solved right away. If you have a problem or dispute with your care or services, you can always file a complaint with us. Issues that are not resolved immediately on the phone and any complaints that come in the mail will be handled according to the procedure described below.
How to File a Complaint
To file a complaint by phone, call Customer Care at 1.800.339.4557, Monday–Friday, 8:30 am–5:00pm. You can also file a written complaint by writing us a letter or submitting a complaint form. To obtain a complaint form, call us at 1.800.339.4557. You may fax your letter or complaint form to 1.914.524.7661, or mail it to:
Hudson Health Plan Customer Care Department
303 South Broadway, Suite 321
Tarrytown, NY 10591-5455
You also have the right to contact the New York State Department of Health by calling them at 1.800.206.8125.
You can ask someone you trust (such as a legal representative, a family member, or friend) to file the complaint for you. If you need our help because of a hearing or vision impairment, or if you need translation services, we can help you. We will not make things difficult for you or take any action against you for filing a complaint.
What Happens Next?
After we receive your complaint, we will send you a letter within 15 business days, letting you know who is working on your complaint and how to contact this person.
Your complaint will be reviewed by one or more qualified people. If your complaint involves clinical matters, your case will be reviewed by one or more qualified health care professionals. If we need any additional information in order to make a decision about your complaint, we will let you know.
After we have reviewed your complaint, we will write to you with our decision and the reason for our decision within 45 days, once we have all the information we need to answer your complaint, but you will hear from us in no more than 60 days from when we received your complaint. When a delay would put your health at risk, we will let you know our decision within 48 hours once we have all the information we need to answer your complaint, but you will hear from us in no more than seven days from the day we get your complaint. We will call you with our decision, and send you a follow up letter with our decision within three business days. If you are not satisfied with our decision, this letter will also inform you of how you may file an appeal.
If you are not satisfied with what we decide, you have 60 days after receiving our letter to file a complaint appeal. You can do this yourself or ask someone you trust to file the appeal for you. The appeal must be in writing. You can write a letter, or call Customer Care at 1.800.339.4557 to request the Plan’s complaint form.
Within 15 business days we will send you a letter letting you know who is working on your appeal, how to contact that person, and if we need additional information.
Appeals on clinical matters will be decided by qualified health care professionals who did not work on your original complaint. All other appeals that are not about clinical matters will be decided by people who work for our Plan at a higher level than those who worked on your original complaint.
After we get all the information we need, we will let you know our decision within 30 business days. If a delay would risk your health you will get our decision within two business days of when we have all the information we need to decide the appeal. We will give you the reasons for our decision and the medical explanation, if it applies. If you are still not satisfied, you or someone on your behalf can file a complaint with the New York State Department of Health at 1.800.206.8125.