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What
to do if You Have a Problem
Patients
or family members have a right to address problems they identify
in a facility without fear of discrimination or punishment. Generally,
when you want help to solve a problem, you should:
- Start by making every
attempt to work it out informally with your facility staff.
- Follow the
steps of your facility's grievance procedure.
- Carefully
review ESRD Network #15 Statement of Patient Rights and Responsibilities.
- See the resources below for additional options.
Quality of Care Issues
If a problem persists and is about quality of care issues you can contact:
Intermountain End-Stage Renal Disease Network
1301 Pennsylvania St, #750
Denver, CO 80203
1-800-783-8818
E-mail: info@nw15.esrd.net
OR
Your State Survey Agency as listed below:
Arizona Dept. of Health Services
Assurance/Licensure, ESRD Surveyor
150 N. 18th Ave, Suite 450
Phoenix, AZ 85007
602-364-3030 |
Nevada Division of Health, Bureau of
Licensure and Certification/EMS
1550 College Pkwy #158
Carson City, NV 89706-7921
775-687-4475 |
Colorado Dept of Public Health
4300 Cherry Creek Dr South
HFD,
Bldg A, 2nd Floor
Denver, CO 80246
1-800-886-7689 (toll free in-state)
303-692-2800 |
Utah Dept of Health, Medicare/Medicaid
Program, Cert/Resident Assessment
ESRD Surveyor
P.O. Box 144103
Salt Lake City, UT 84114-4103
1-800-662-4157 (toll free in-state)
801-538-6158 |
New Mexico Dept of Health, Health Facility
Licensing and Cert., ESRD Surveyor
2040 S Pacheco St, 2nd Floor #413
Santa Fe, NM 87505
1-800-752-8649 (toll free in-state)
505-476-9025 |
Wyoming Dept of Health
Office of Health Quality
ESRD Surveyor
2020 Carey Ave, 8th Floor
Cheyenne, WY 82002
307-777-7123 |
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The
Network's Role
The Network is a facilitator. It can assist in the resolution of
a grievance by acting as a third party or intermediary between a
patient and a facility or a professional provider. If you need help,
or information, you can write or call the Network office at:
Intermountain
End-Stage Renal Disease Network
1301 Pennsylvania St #750
Denver, CO 80203-5012
303-831-8818 or toll free 1-800-783-8818 and 1-888-777-0105
Here are some
rules you will have to follow:
- You
are asked to confirm the grievance in writing if you make the
initial contact by phone.
- You
may designate anyone you choose as your representative, though
you must designate in writing if you want someone to act in your
behalf.
- You
are not required to use the facility grievance procedure before
contacting the Network, but it is recommended in most cases; however,
if you fear reprisal by your facility, you are free to contact
the Network first.
- You
can withdraw a grievance at any time.
The
Network will:
- Keep your
identity confidential and will not release it without your permission.
- Send you
a written acknowledgment within 5 days that your complaint has
been received.
- Respond in
writing if we determine that the problem is not a Network issue,
or is more appropriately handled by another agency.
- Conclude
our mediation/resolution activities within 90 days of receipt
of the inquiry, and make a written response to you, including
results, agreements and options to follow if you are not satisfied.
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Medicare Payment Issues
Network #15 cannot handle issues dealing with
money or payment of bills. Here are phone numbers for Medicare billing issues for patients living in:
Arizona, Colorado, and Nevada, and Wyoming - Noridian Mutual Insurance Co. - (800) 444-4606
Nevada - Blue Cross Blue Shield of Arkansas - (800) 423-2925
New Mexico and Utah call - Regence Blue Cross Blue Shield - (800) 426-3477
For Medicare coverage issues all patients may call the Medicare Hotline - (800) 633-4227.
See our ESRD Medicare Coverage page for additional information on this subject.
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Licensing and Certification Issues
State or Federal licensing or certification
issues are handled by the CMS Regional offices. Here
is the contact information for patients living in:
Arizona or
Nevada
DHHS, CMS Region IX, Providers & Policies
4th Floor, 75 Hawthorne St
San Francisco, CA 94105
(415) 744-3628
Colorado,
Utah, or Wyoming
DHHS, CMS Region VIII, BMSO
1600 Broadway St #700
Denver, CO 80202
(303) 844-7125
New Mexico
DHHS,
Region VI, DHSQ, CMS
1301 Young ST, #833
Dallas, TX 75202
(214) 767-6423
Your identity will be kept confidential throughout the process unless
you specifically authorize a release.
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Intermountain
End-Stage Renal Disease Network, Inc.
1301 Pennsylvania St #750, Denver, CO 80203-5012
Phone: 303-831-8818 Fax: 303-860-8392
Toll free for patients only: 1-800-783-8818 or 1-888-777-0105 |
