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.
For complaints about a denial of a request for coverage of healthcare services, prescription drugs, or payment for services or drugs you’ve already received, you need to file an appeal.
If you file a standard grievance, we will respond within 30 calendar days after receiving your complaint.
If you file a grievance because you are unhappy that we did not review a coverage decision or appeal for you under expedited timeframes, we will respond to that complaint within 24 hours. We call that type of complaint an expedited grievance.
Also, if we ever take extra days to investigate an appeal or grievance for you (which is called taking an extension), you can file a complaint about that and we will also respond to your concern within 24 hours.
Please contact Customer Service for information about filing an expedited grievance. The contact information for Customer Service can be found in the How to file a grievance area below.
You have the right to have another person file a grievance on your behalf. The person you name would be your appointed representative. If you want someone to act for you, you and that person must sign and date the Appointment of Representative form and then mail the completed form to our Customer Service team at this address:
Health Alliance Plan
Attn: Customer Service Department
1414 E Maple Rd
Troy, MI 48083
Learn more about appointing a representative.
Contact us right away. We may be able to answer your questions or resolve your complaint over the phone.
You may file a grievance either orally or in writing, by one of the following methods:
Call the customer service department for your plan:
HMO and HMO-POS plans
PPO plans
D-SNP and C-SNP plans
Our team members can take your call during the following times:
At all other times, you may access our interactive voice recording system at the same number. Leave your name and phone number. A customer service representative will return your call the next business day. Please do not share personal health information when you leave your message.
(313) 664-5866
Health Alliance Plan
Attn: Appeal and Grievance Department
1414 E Maple Rd
Troy, MI 48083
For information about filing a grievance through Medicare, visit Medicare Claims, appeals and complaints.
If you’re concerned about the quality of care you received, including care during a hospital stay, you also can file a complaint with an independent organization called Livanta LLC.
Write, call or fax Livanta at:
Livanta LLC
Attn: BFCC-QIO Program
10820 Guilford Rd, Suite 202
Annapolis Junction, MD 20701
Phone: (888) 524-9900
TTY: (888) 985-8775
Fax: (855) 236-2423
You also may refer to the chapter titled What to do if you have a problem or complaint (coverage decisions, appeals, complaints) in your Evidence of Coverage. If you prefer to contact Medicare directly, you can call 1-800-Medicare or (800) 633-4227 24 hours a day, seven days a week. TTY users should call (877) 486-2048. Or you can file a complaint on the Medicare website.
