Pennsylvania

Claims & billing

Benefits Coordination & Recovery Center (BCRC)

Benefits Coordination & Recovery Center (BCRC)
Questions regarding — Claims & billing
Medicare Secondary Payer, and who pays first.
Toll free: (855) 798-2627

Carrier

Highmark Medicare Services
Questions regarding — Claims & billing
Part B bills and services.
Toll free: (800) 633-4227

DME MAC -- Durable Medical Equipment Medicare Administrative Contractor

National Heritage Insurance Company
Questions regarding — Claims & billing
Bills for durable medical equipment and a list of approved suppliers of this equipment.
Toll free: (800) 633-4227

Fiscal Intermediary

Highmark Medicare Services
Questions regarding — Claims & billing
Part A bills and services, hospital care, skilled nursing care, and fraud.
Toll free: (800) 633-4227

OIG (DHHS) -- Office of the Inspector General (Department of Health and Human Services)

Department of Health and Human Services - Office of Inspector General
Questions regarding — Claims & billing
Reporting fraud.
Toll free: (800) 447-8477
TDD: (800) 377-4950
Local Phone: (202) 619-1343

RHHI -- Regional Home Health Intermediary

Noridian Administrative Services
Questions regarding — Claims & billing
Home health, hospice care, and fraud.
Toll free: (800) 633-4227

RRB Carrier - Railroad Retirement Board Carrier

Noridian
Questions regarding — Claims & billing
(For Railroad Retirement beneficiaries only) - Part B bills and services.
Toll free: (888) 355-9165
Local Phone: (877) 288-7600

Complaints about my care or services

Accreditation Association for Ambulatory Health Care

Accreditation Association for Ambulatory Health Care
Questions regarding — Complaints about my care or services
Finding out if urgent care centers and ambulatory surgical centers are accredited or not.
Local Phone: (847) 853-6060

American Association for Accreditation of Ambulatory Surgical Facilities

American Association for Accreditation of Ambulatory Surgical Facilities
Questions regarding — Complaints about my care or services
Finding out if an ambulatory surgical center is accredited or not.
Toll free: (888) 545-5222
Local Phone: (847) 775-1970

American Board of Medical Specialties

American Board of Medical Specialties
Questions regarding — Complaints about my care or services
Finding out if a doctor is board certified.
Toll free: (866) 275-2267
Local Phone: (312) 436-2600

American Hospital Association

American Hospital Association
Questions regarding — Complaints about my care or services
Finding a voluntary list of patients' rights in a hospital.
Toll free: (800) 424-4301
Local Phone: (312) 422-3000

Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO)

Livanta, LLC
Questions regarding — Complaints about my care or services
Complaints about quality of care, and filing an appeal or complaint.
Toll free: (866) 815-5440
TDD: (866) 868-2289

Center for Health Dispute Resolution (CHDR)

MAXIMUS Center for Health Dispute Resolution (CHDR)
Questions regarding — Complaints about my care or services
Requesting external reviews of Medicare managed care denials.
Local Phone: (585) 425-5210

College of American Pathologists

College of American Pathologists
Questions regarding — Complaints about my care or services
Finding out if the lab where your blood tests are sent is accredited or not.
Toll free: (800) 323-4040
Local Phone: (847) 832-7000

ESRD -- End-Stage Renal Disease Networks

ESRD Network 4, Inc.
Questions regarding — Complaints about my care or services
Where to submit a complaint about the quality of care I received from my kidney dialysis facility.
Toll free: (800) 548-9205
Local Phone: (610) 265-2418

ESRD State Survey Agency

Department of Health of Pennsylvania - Division of Home Health
Questions regarding — Complaints about my care or services
Complaints about the quality of care in dialysis facilities.
Toll free: (800) 225-7223
Local Phone: (717) 772-2762

Home Health Agency

Department of Health of Pennsylvania - Division of Home Health
Questions regarding — Complaints about my care or services
Home Health Care which is skilled nursing care and certain other health care services that you get in your home for the treatment of an illness or injury.
Toll free: (800) 254-5164
Local Phone: (717) 783-1379

Joint Commission on Accreditation of Healthcare Organizations (JCAHO)

Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
Questions regarding — Complaints about my care or services
Finding out if your health care organization is accredited or not.
Local Phone: (630) 792-5800

Medicaid - Report Fraud

Department of Public Welfare
Questions regarding — Complaints about my care or services
Report Medicaid fraud and abuse.
Toll free: (866) 379-8477

Nursing Home State Survey Agency

Pennsylvania Department of Health
Questions regarding — Complaints about my care or services
Where to submit a complaint about the quality of life or quality of care inside a nursing home.
Toll free: (800) 254-5164
Local Phone: (717) 787-1816

Office for Civil Rights

Office for Civil Rights of the Mid-Atlantic
Questions regarding — Complaints about my care or services
Submitting a complaint about discrimination.
Local Phone: (215) 861-4441

Ombudsman

Department of Aging of Pennsylvania
Questions regarding — Complaints about my care or services
Obtaining information on nursing homes or resolving problems between nursing homes and residents or their families.
Local Phone: (717) 783-1550

Quality Innovation Network Quality Improvement Organization (QIN-QIO)

Quality Insights Quality Innovation Network
Questions regarding — Complaints about my care or services
Local and community level projects to improve patient safety, reduce harm, and improve clinical care.
Local Phone: (304) 346-9864

Senior Medicare Patrol (SMP)

CARIE
Questions regarding — Complaints about my care or services
Complaints about quality of care, and filing an appeal or complaint.
Toll free: (800) 356-3606

General health & health conditions

Agency for Healthcare Research and Quality (AHRQ)

Agency for Healthcare Research and Quality (AHRQ)
Questions regarding — General health & health conditions
Ordering brochures on Choosing a Hospital. Choosing Treatments and Choosing a Hospital.
Toll free: (800) 358-9295
TDD: (888) 586-6340

American Association of Kidney Patients

American Association of Kidney Patients
Questions regarding — General health & health conditions
Educational materials for people with kidney disease.
Toll free: (800) 749-2257
Local Phone: (813) 636-8100

American Cancer Society

American Cancer Society
Questions regarding — General health & health conditions
Finding information on cancer.
Toll free: (800) 227-2345
TDD: (866) 228-4327

American Heart Association

American Heart Association
Questions regarding — General health & health conditions
Finding information on heart disease.
Toll free: (800) 242-8721
Local Phone: (214) 570-2000
Spanish Phone: (800) 242-8721

American Kidney Fund

American Kidney Fund
Questions regarding — General health & health conditions
Financial assistance and educational materials for people with kidney disease.
Toll free: (800) 638-8299
Local Phone: (301) 881-3052
Spanish Phone: (866) 300-2900

Internal Revenue Service

Internal Revenue Service
Questions regarding — General health & health conditions
Obtaining materials/forms for income tax filing and how Medicare Savings Accounts can affect my income taxes.
Toll free: (800) 829-1040

National Cancer Institute's Cancer Information Service

National Cancer Institute's Cancer Information Service
Questions regarding — General health & health conditions
Information on cancer treatments, clinical trails, alternative medicine, coping with side effects, and other cancer related information.
Toll free: (800) 422-6237

National Institute on Aging Information Center

National Institute on Aging Information Center
Questions regarding — General health & health conditions
Discussing health concerns, medicines, and other issues important to older people.
Toll free: (800) 222-2225
TDD: (800) 222-4225

National Kidney and Urologic Diseases Information

National Kidney and Urologic Diseases Information
Questions regarding — General health & health conditions
Educational materials for people with kidney disease.
Toll free: (800) 891-5390
Local Phone: (301) 654-4415

National Kidney Foundation, Inc.

National Kidney Foundation, Inc.
Questions regarding — General health & health conditions
Support groups and educational materials for people with kidney disease.
Toll free: (800) 622-9010
Local Phone: (212) 889-2210

Health care facilities & services in my area

American Self-Help Clearinghouse

American Self-Help Clearinghouse
Questions regarding — Health care facilities & services in my area
Finding specific health support groups in your area.
Toll free: (800) 367-6274
Local Phone: (973) 989-1122

CHIP -- Children's Health Insurance Program

Pennsylvania's Children's Health Insurance Program
Questions regarding — Health care facilities & services in my area
Health insurance programs to children whose families earn too much to be eligible for Medicaid, but not enough to purchase private insurance.
Toll free: (800) 986-5437

Eldercare Location

DC longterm care Ombudsman program
Questions regarding — Health care facilities & services in my area
Finding necessary and convenient services that serve the elderly in their community.
Toll free: (800) 677-1116
Local Phone: (202) 434-2120

Primary Care Association

Forum for Primary Health Care of Pennsylvania
Questions regarding — Health care facilities & services in my area
Finding a Federally Qualified Health Center (FQHC) closest to me to help me lower my health care costs. FQHCs include community health centers, tribal health clinics, migrant health services, and health centers for the homeless.
Toll free: (866) 944-2273
Local Phone: (717) 761-6443

State Hospice Organization

Pennsylvania Hospice Network
Questions regarding — Health care facilities & services in my area
To find a hospice program in my area.
Toll free: (866) 554-6774
Local Phone: (717) 533-4002

Help with my Medicare options & issues

1-800-MEDICARE

1-800-MEDICARE
Questions regarding — Help with my Medicare options & issues
General Medicare information, ordering Medicare booklets, and information about health plans.
Toll free: (800) 633-4227

CMS RO - Centers for Medicare & Medicaid Services Regional Office

CMS, Philadelphia Regional Office
Questions regarding — Help with my Medicare options & issues
Information on local seminars and health fairs on Medicare health plan choices, or to report a complaint directly to CMS.
Local Phone: (215) 861-4140

RRB -- Railroad Retirement Board

Railroad Retirement Board
Questions regarding — Help with my Medicare options & issues
(For Railroad Retirement beneficiaries only) - RRB benefits, lost RRB Medicare card, address change, and enrolling in Medicare.
Toll free: (877) 772-5772

SHIP -- State Health Insurance Assistance Program

APPRISE
Questions regarding — Help with my Medicare options & issues
Personalized health insurance counseling
Toll free: (800) 783-7067
Local Phone: (717) 783-1550

SSA -- Social Security Administration

Social Security Administration
Questions regarding — Help with my Medicare options & issues
Changing my address, Medicare Part A or Part B, lost Medicare card, and Social Security benefits.
Toll free: (800) 772-1213

State Department of Insurance

Insurance Department of Pennsylvania
Questions regarding — Help with my Medicare options & issues
Medigap Policies
Toll free: (877) 881-6388
Local Phone: (717) 787-2317

Other insurance programs

CHIP -- Insure Kids Now

Children's Health Insurance Program
Questions regarding — Other insurance programs
Children's Health Insurance Program
Toll free: (877) 543-7669

Department of Defense

Department of Defense
Questions regarding — Other insurance programs
Whether I qualify for military retiree health care benefits.
Local Phone: (703) 571-3343

Department of Veterans Affairs

Department of Veterans Affairs
Questions regarding — Other insurance programs
VA medical benefits.
Toll free: (800) 827-1000

Federal Black Lung Program

Federal Black Lung Program
Questions regarding — Other insurance programs
Finding out where my doctor should send the bills for the diagnosis and treatment of my black lung disease.
Toll free: (800) 638-7072

HUD -- U.S. Department of Housing

U.S. Department of Housing and Urban Development (HUD)
Questions regarding — Other insurance programs
Information and services about homes and communities for citizens and for HUD's current and potential home buyers.
Toll free: (800) 569-4287
Local Phone: (202) 708-1112

Office of Personnel Management

Office of Personnel Management
Questions regarding — Other insurance programs
Claims and other issues for retired federal employees and their dependents/survivors.
Toll free: (888) 767-6738
TDD: (800) 878-5707
Local Phone: (202) 606-1800

State Health Departments

Pennsylvania Department of Health
Questions regarding — Other insurance programs
Health based programs and services.
Toll free: (877) 724-3258

State Medical Assistance Office

Department of Public Welfare of Pennsylvania
Questions regarding — Other insurance programs
Medicaid program
Toll free: (800) 692-7462

About Pennsylvania

Pennsylvania, officially the Commonwealth of Pennsylvania, is a state located in the Northeastern, Great Lakes and Mid-Atlantic regions of the United States. The Appalachian Mountains run through its middle. The Commonwealth is bordered by Delaware to the southeast, Maryland to the south, West Virginia to the southwest, Ohio to the west, Lake Erie and the Canadian province of Ontario to the northwest, New York to the north, and New Jersey to the east.

Pennsylvania is the 33rd-largest state by area, and the 5th-most populous state according to the most recent official U.S. Census count in 2010. It is the 9th-most densely populated of the 50 states. Pennsylvania's two most populous cities are Philadelphia (1,580,863), and Pittsburgh (302,407). The state capital and its 10th-largest city is Harrisburg. Pennsylvania has 140 miles (225 km) of waterfront along Lake Erie and the Delaware Estuary.

The state is one of the 13 original founding states of the United States; it came into being in 1681 as a result of a royal land grant to William Penn, the son of the state's namesake. Part of Pennsylvania (along the Delaware River), together with the present State of Delaware, had earlier been organized as the Colony of New Sweden. It was the second state to ratify the United States Constitution, on December 12, 1787. Independence Hall, where the United States Declaration of Independence and United States Constitution were drafted, is located in the state's largest city of Philadelphia. During the American Civil War, the Battle of Gettysburg was fought in the south central region of the state. Valley Forge near Philadelphia was General Washington's headquarters during the bitter winter of 1777–78.

Source: Wikipedia