When you get emergency care or get treated by an out-of-network provider at an innetwork hospital or ambulatory surgical center, you are protected from surprise billing or
balance billing.
Pain Treatment, MD provides aids, supports, and services to patients with disabilities to communicate effectively with their Pain Treatment, MD care team at no cost, such as:
If you or your caregiver(s) need interpreter services to communicate effectively with your Pain Treatment, MD care team, please contact the Director of Practice Management at 844-215-0731. Please let your Pain Treatment, MD care team know what your preferred language is.
If you believe that Pain Treatment, MD has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you may file a grievance with:
You may file a grievance in person, by mail, or by fax. If you need help filing a grievance, the Director of Practice Management is available to help you. You may also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at:
U.S. Department of Health and Human Services
200 Independence Avenue
SW Room
509F HHH Building Washington,
D.C. 20201
1-800-368-1019, 800-537-7697 (TDD)
Complaint forms are available at: http://www.hhs.gov/ocr/office/file/index.html
