
IF YOU HAVE A COMPLAINT
CompBenefits is committed to offering outstanding service to
its members. To this end, CompBenefits has established a system to respond
to complaints related to all aspects of care and services provided by the
organization. If you have a concern about your dental care or coverage, the
way we manage it, or a decision we have made, we want to know. Our goal is
to acknowledge and resolve complaints in a timely manner, in accordance with
internal policy and regulatory requirements. We monitor complaints and use
this feedback from members to improve our performance.
Definitions
Complaint - a verbal or written expression of
dissatisfaction with the plan, regarding any process. A complaint is not a
misunderstanding or misinformation that is resolved promptly by supplying
the appropriate information or clearing up the misunderstanding to the
satisfaction of the member.
Appeal process - the formal process by which the plan offers
the subscriber a mechanism to request a secondary review of a complaint
resolution.
Complaints
Our Member Services Department is available by phone Monday
through Friday, 8:00 AM to 6:00 PM Eastern Standard Time to assist members
in addressing any dissatisfaction with their dental plan benefits and/or
participating dental office. You can call Member Services at 1-877-531-3026
or submit a complaint in writing. Grievances submitted in writing should be
mailed to:
Grievance Department
CompBenefits Corporation
5775 Blue Lagoon Drive
Suite 400
Miami, FL 33126
If you submit a written complaint please include your
concern, specific details, dates, and your name and contact information.
Should you have any question about submitting a written complaint, call the
Member Services Department at 1-877-531-3026. Complaints must be submitted
to CompBenefits within one year of the occurrence of events upon which the
grievance is based. Your complaint will be acknowledged in writing within
five days of receipt. Written complaints will be researched and resolved
within 30 days in accordance with the regulatory requirements of the Office
of Insurance Regulation. A response and explanation letter with CompBenefits'
resolution will be sent to you. The letter will include specific clinical
reasons and/or reference to your Handbook and Evidence of Coverage that
apply.