The following is a Grievance Complaint Form that you may complete in order to expedite your complaint. If you need help in filling out this form, please call us at 1-800-344-4222. You will receive an Acknowledgement of Receipt of Complaint letter within five days of receipt of the complaint and a Statement of Complaint Resolution letter within five days of a decision, but no later than thirty calendar days from receipt of the complaint. The Acknowledgement of Receipt of Complaint letter acknowledges that we received your complaint.
If you have any questions regarding the grievance process or your specific grievance, please contact a Clinical Manager at 1-800-344-4222. By law, all grievances must be resolved within thirty (30) days of receipt of the complaint.