PPO Quality Ratings - Member Complaints
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Member Complaints 2014 Edition

Why is it important to resolve member complaints?

Medical care and health insurance can be complicated. The rules and responsibilities can be confusing. Sometimes there are mistakes and misunderstandings, so it is important that your PPO helps you when problems occur.

What can PPOs do to resolve complaints?

Highly rated PPOs solve your problems quickly by having well-trained staff and good business systems. These PPOs have knowledgeable and respectful staff. They also have systems and clear rules to quickly troubleshoot your complaints and to help settle any disagreements.

What do the scores mean?

The scores show the percentage of health plan members who reported that they were satisfied with the PPO's handling of a problem when they called or wrote to the plan. The higher the number, the more members highly rate their plan on handling member complaints.

The scores are based on information from a survey of a sample of PPO members in 2012.

Look for differences of at least 4%. Smaller differences usually are not significant.

Member Complaints

 
(Worse)
0%
(Better)
100%
 
Anthem Blue Cross PPO 64% Horizontal bar, 64 units
Blue Shield of California/Blue Shield Life PPO 60% Horizontal bar, 60 units
UnitedHealthcare Insurance Co., Inc. 54% Horizontal bar, 54 units
Health Net PPO 52% Horizontal bar, 52 units
CIGNA PPO 31% Horizontal bar, 31 units
Why isn't my health plan listed?