The Department of Insurance is moving to 3200 Beechleaf Ct, Raleigh the week of Dec. 11, but always available to help you by calling 855-408-1212 (toll free)
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Bulletin 23-B-09 - Extra RX During State of Emergency
This bulletin reminds health benefit plans of compliance requirements for operations under a state of emergency for purposes of obtaining extra prescriptions
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Provider/Pharmacy Complaints Against Health Plans/PBM’s
Tab/Accordion Items
Attempt to resolve your issues with the insurance company.
Reach out to the company’s Provider Relations Team relating to recurring issues such as coding errors, delayed payments or denied claims.
Document phone calls to the company-name of person you speak to, date of call and brief summary of conversation.
Keep copies of all written communications.
Be sure to complete all levels of contractual appeals available.
Look closely at patient’s insurance card. If the card names the employer, you should check to see if the plan is self-funded. DOI has no regulatory authority over self-funded plans.
Call the Consumer Services Division at 855-408-1212 prior to submitting written complaint.
Discuss your concerns regarding multiple instances of the same issue and help you determine if filing a complaint is an appropriate course of action.
Initiate regulatory action as the Department deems appropriate.
Resolve your contract dispute issues.
Determine the value of a claim or the amount of money owed to you.
Help you facilitate claim payment in the absence of a statutory issue or policy provision.
Address issues with plans not subject to the insurance laws of North Carolina.
Consult with you if you are represented by an attorney.