Grievances & Complaints
File a grievance within your insurance company if:
- You have a claim denial due to specific benefits exclusions or restrictions.
- You want to file a formal complaint regarding any aspect of the services provided by your healthcare plan.
As with the appeals processes, the process for filing a grievance will vary from health plan to health plan. Be sure to call your health plan’s customer service department to obtain the specific details on how to file a grievance.
File a complaint with your state’s Department of Insurance if:
- Your insurance company has denied you medical service(s) or treatment that is covered or that you feel should be covered in your plan.