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Consumer Medicare Resources

Complaints

What should I do if I am concerned about or not satisfied with the quality of care I received?
1. Call Delmarva at 1-800-492-5811 and describe your concern. One of our trained staff will listen and help you decide what to do. One of your choices is to make a formal complaint.

2. If you decide you want to make a formal complaint, we can help you put it in writing. Once Delmarva receives the written complaint, the quality of care review will begin.

This is a free service for Medicare members.

Your case may be suitable for mediation, a new alternative to resolve your concerns by talking directly with your doctor.

Who conducts the review and what does it include?
Depending on the case, any of our physician reviewers can review your complaint. (A physician reviewer is a practicing physician who works with Delmarva to address quality of care concerns.) A case manager will contact you once the complaint is filed and serve as your point of contact throughout the process.

The physician reviewer looks at all aspects of care surrounding your complaint, and makes an initial finding that is shared with the healthcare provider or facility your complaint is related to. Your healthcare provider/facility also has the opportunity to comment. Delmarva works directly with you and your provider to resolve the problem and make sure that you and other Medicare members receive the best care possible.

The entire process takes anywhere from three to six months.

If I am concerned about the quality of healthcare I received in another state, can Delmarva review it?
Each state has an organization like Delmarva. To request a review or to file a complaint about the quality of care you received in a state outside Maryland, you must call the appropriate organization.

Call 1-800-MEDICARE (1-800-633-4227) to obtain the phone number, or visit MedQIC.Org to find the quality improvement organization for each US state and territory.