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Grievances
Tell us what’s not working so we can fix it
You have the right to make a complaint about concerns or problems related to your coverage or care.
A grievance is a type of complaint you can make about us or one of our network providers or pharmacies. For example, you could file a complaint if you have a problem with the quality of your care, waiting times for appointments, or the cleanliness or condition of your doctor's office.
Grievances don’t involve coverage or payment disputes. For complaints about a denial of a request for coverage of health care services, prescription drugs or payment for services or drugs you’ve already received, you need to file an appeal.
If you file a grievance, we’ll respond within 30 calendar days after receiving your complaint. If you file a grievance because we denied an “expedited coverage decision,” an “expedited appeal” or if we took an extension on your appeal, we’ll automatically give you an “expedited grievance.”
If you have an “expedited grievance,” we’ll respond within 24 hours. Please contact Customer Service for information about filing an “expedited grievance.”