If you have questions, concerns or a potential dispute regarding your benefits, start by contacting our benefits specialists.
Our knowledgeable benefits specialists can assist you with most benefits-related matters. If you have a benefits dispute, our Ombudsperson Services can assist you.
An ombudsperson acts as a neutral party while helping with your benefit concerns. The goal is to offer a fair resolution for all parties while sticking to program policies, contracts and the law.
An ETF Ombudsperson Can Help
- When a prior authorization request has been denied.
- When claims have not been processed correctly.
- When you have been told you have no insurance coverage.
- If you want to file a grievance or an independent review.
- If you receive a bill for services that were covered in the past.
An ETF Ombudsperson Cannot
- Guarantee a favorable outcome.
- Change any plan’s policy.
- Authorize claims payment.
- Make medical determinations.
- Make ETF policy or management decisions.