If you believe your Medical Provider Network violates requirements, you may submit a written complaint directly with the Medical Provider Network contact. The written complaint must detail the alleged violations and include the following information. When the alleged violation occurred If the suspected violation is still occurring What, if anything, the Medical Provider Network has done to remedy the violation If the violation has had any impact on the injured worker The Medical Provider Network has 30 days to respond to the complaint from the date the complaint was received. Within those 30 days, the Medical Provider Network must respond by taking responsibility and fixing the violations or disputing the claim in writing. If the alleged violation is not corrected within those 30 days and the Medical Provider Network has submitted their dispute, the complainant can file a written complaint with the Division of Workers’ Compensation. The Division of Workers’ Compensation has its own complaint form that must be filled out and submitted to them. If the violation is more severe and resulted in an immediate threat to the worker’s life, the complainant can file a complaint with the Medical Provider Network and the Division of Workers’ Compensation at the same time.