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  4. Report a Critical Incident

Report a Critical Incident  

Have you seen a doctor or caregiver mistreat a child or adult? 

Mistreatment could include actions that cause physical, mental, or financial harm. These situations are called critical incidents. They raise serious red flags about whether a Highmark Health Options Duals member is being treated fairly and safely.

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Report a critical incident

Call us Monday–Friday, 8 a.m. - 5 p.m.

Duals Member Services: 1-855-401-8251 (TTY: 711)

Member Services: 1-844-722-5837 (TTY 711)

Reporting Wrong Actions is Important

Tell us right away if you think doctor or paid caregiver is involved in a critical incident and has mistreated a Highmark Health Options Duals member.

Here’s what to look out for:

  • Caused a severe injury. This includes a broken bone, deep cut, or serious burn.
  • Denied a member’s basic needs. This includes food, medicine, personal care items, and supervision.
  • Forced or tricked a member into sexual activity.
  • Injured a member or caused emotional distress.
  • Stolen a member’s money or medicine.
  • Used a member’s checkbook, debit card, or credit card without permission.
  • Was unprofessional. This includes yelling at a member or refusing to do their job.