Health Plan Feedback and Compliments

At Carolina Complete Health, we want to ensure you are receiving the highest quality of care on your journey to better health.

Please use the form below to leave a compliment or provide feedback about Carolina Complete Health (CCH), our Providers/Vendors or services.

Contact Us Form

Who are you? * Member Provider

Member Information

First Name *

Last Name *

Medicaid ID # *

Phone Number *

Email *

Name of Parent / Legal Guardian (if applicable)

Feedback Details

Enter a brief description of the feedback you would like to share *

Is there a specific person you want to recognize? * Yes No

If yes, please enter their name *

If you are not “very satisfied,” what can we do to improve our services? *

Provider Information

Provider/Group Name *

Provider Tax ID Number *

Provider NPI Number *

Name of Person Completing Form (Requestor) *

Requestor Phone Number *

Requestor Email *

Feedback Details

Enter a brief description of the feedback you would like to share *

Is there a specific person you want to recognize? * Yes No

If yes, please enter their name *

If you are not “very satisfied,” what can we do to improve our services? *

This form will send your message to Carolina Complete Health as an email. The email is not encrypted and is not transmitted in a secured format. By communicating with Carolina Complete Health through email, you accept the risks associated thereof. Carolina Complete Health does not accept responsibility or liability for any loss or damage arising from the use of email. To ensure the safety of your protected health information (PHI), please send us a message through the Secure Member Portal or Provider Portal, or you can call us at 1-833-552-3876 (TTY 711) to speak directly to a member service representative.

If you need assistance filling out this form, please call Member Services at 1-833-552-3876 (TTY 711).