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Bureau of Insurance

Managed Care Health Insurance Plan Problems and Questions

If you have experienced a problem with your Managed Care Health Insurance Plan (MCHIP), or if you have a question regarding your MCHIP, you should first contact your MCHIP for assistance. Contact information is provided on your insurance card and also in documents the MCHIP provides to you such as the evidence of coverage. Usually the MCHIP can answer your question. If you do not understand your MCHIP's response, disagree, still have questions or are uncertain about something, contact this office for help.

If you have an informal question or concern, you can contact us for assistance by calling toll-free 877-310-6560 or if you're in the Richmond metropolitan area you can contact us at 804-371-9032. You can also write to us at Office of the Managed Care Ombudsman, Bureau of Insurance, P.O. Box 1157, Richmond, VA 23218. Our fax number is 804-371-9944. You can also contact us via electronic mail at ombudsman@scc.virginia.gov We will respond to your question or concern related to your MCHIP or to managed care.

If you would like this office to formally assist you appeal an adverse decision that your Managed Care Health Insurance Plan (MCHIP) has made, then please complete a Life and Health Insurance Complaint/Appeal Form which you can download from this page. When you return the form, please include copies of any denial letters you have received from your MCHIP. This office will then assist you in the appeals process, and make sure that you understand your rights. If necessary, we will contact your MCHIP to clarify any issues related to your appeal that are not clear or that are in dispute.

Life and Health Insurance Complaint/Appeal Form