Establishment and Maintenance of Complaint System; Maintenance of Records of Complaints; Summary Reports; Examination of System

  1. Law
  2. Georgia Code
  3. Insurance
  4. Health Maintenance Organizations
  5. Establishment and Maintenance of Complaint System; Maintenance of Records of Complaints; Summary Reports; Examination of System

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  1. Every health maintenance organization shall establish and maintain a complaint system which has been approved by the Commissioner of Insurance to provide reasonable procedures for the resolution of written complaints initiated by enrollees or providers concerning health care services.
  2. The health maintenance organization shall maintain records of written complaints concerning health care services for five years from the time the complaints are filed and shall submit to the Commissioner of Insurance a summary report at such times and in such format as the Commissioner of Insurance may require.
  3. The Commissioner of Insurance may examine the complaint system at any time.

(Code 1933, § 56-3610, enacted by Ga. L. 1979, p. 1148, § 1; Ga. L. 1986, p. 676, § 7; Ga. L. 2004, p. 493, § 3.)


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