The grievance process allows the member, or the member’s authorized representative acting on behalf of the member (or provider acting on the member’s behalf with the member’s written consent) to file a grievance either orally or in writing. A grievance is defined as an expression of dissatisfaction about any matter other than an “adverse action.”
Grievances may be filed within 60 calendar days of the occurrence of the matter that is the subject of the grievance. Grievances are acknowledged within three business days and resolved within 30 calendar days. Grievances can be submitted in writing or via the Provider Portal.
If you have any questions or concerns, please contact Provider Services at 1-844-607-2831 or speak with your Provider Engagement Representative.