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Filing a Complaint

What should I do if I have a complaint? Who do I call?

We want to help. If you have a complaint, please call us toll-free at 800-964-2247 to tell us about your problem. A Cook Children’s Health Plan Member Services advocate can help you file a complaint. Most of the time we can help you right away or within a few days.

Where can I mail a complaint?

For written complaints, please send your letter to Cook Children’s Health Plan. Your letter must state your name, your member ID number, your phone number and address and the reason for your complaint. Please send your letter to:

Cook Children’s Health Plan
Attention: Complaints and Appeals
P.O. Box 2488
Fort Worth, TX 76113-2488

What are the requirements and timeframes for filing a complaint?

There is no time limit on filing a complaint with Cook Children’s Health Plan. We will send you a response letter telling you what we did about your complaint.

How long will it take to process my complaint?

Most of the time we can help you right away or within a few days. You will get a response letter within 30 days from when your complaint was received by Cook Children’s Health Plan.

Can someone from Cook Children’s Health Plan help me file a complaint?

Yes. Member Services can help you file a complaint. Call us at 800-964-2247.  

Do I have the right to meet with a Complaint Appeal Panel (CAP)?

Yes. You have the right to appear in person before the CAP or send a written appeal to the CAP.

If I am not satisfied with the outcome, who else can I contact?

If you are not satisfied with the answer to your complaint, you can notify the Texas Department of Insurance by calling 800-252-3439. If you would like to make your request in writing, send it to:

Texas Department of Insurance,
Attention: Consumer Protection
P.O. Box 149091
Austin, TX 78714-9091

To submit your complaint online, visit tdi.texas.gov/consumer/complfrm.html.

 

For questions about your complaint or appeal or to get the status of your complaint or appeal, please call Member Services at 1-800-964-2247.