Skip Navigation

Buscar
english
español

Comuníquese con nosotros
Noticiero
Eventos
Capacitación al proveedor

Superior Health Plan

Encuentre a un Doctor
Para miembros
Para proveedores

Search Our Website

Home > File a Complaint

File a Complaint

Are you a?*
- Member
- Provider
Is this a Medicare Complaint?*
- Yes
- No
Is there an Appeal Element?*
- Yes
- No
Is this complaint related to a prescription drug?*
- Yes
- No
Member First Name (required)*
Member Last Name (required)*
Member Medicaid or CHIP ID Number (required)*
Complainant Email Address
Complainant Phone Number
Member County
Provider
Complaint Summary (required)*
Member Date Of Birth
Complainant Relationship to Member (required)*
Other - Relationship to member (required)*
Complainant Address*
Street AddressCityStateZip Code
Complaint Type (required)*
Other Complaint Type (required)*
Form Completed By (required)*
Name of Person Completing Form (required)*
How can Superior resolve your issue? (required)*
Provider Name (required)*
FirstLast
Practice/Clinic/Facility Name
Email Address
Phone Number (required)*
County
Member
Complaint Summary (required)*
Address (Required)*
Street AddressCityStateZip Code
Are you a contracted provider?
- Yes
- No
NPI (required)*
Tax ID (required)*
Provider ID
Complaint Type (required)*
Complaint Type Other*
Form Completed By (required)*
Name of Person Completing Form (required)*
How can Superior resolve your issue? (required)*

Nuestra empresa

Acerca de Nosotros
Carreras

Enlaces rápidos

Miembros
Recursos para Proveedores
Capacitación al proveedor

Comuníquese con nosotros

Follow Us on RSS

Mapa de Sitios
Términos y condiciones
Declaración de HIPPA
Normas sobre la privacidad

Copyright © 2012, Centene Corporation