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Member Complaints

About This Topic

One clear signal about an HMO’s service and care is the rate at which members call or write with concerns or complaints. One way to measure HMO complaints is through surveys that ask members if they called or wrote their HMO with a complaint.

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Why Is It Important?

The best HMOs have fewer member complaints because their members know what to expect. These HMOs clearly explain what services are covered, what the costs are, how to find a doctor, and how to follow the rules to get care and services.