Grievances and Appeals
As a Community Health Plan member, you have the right to file a complaint or to appeal a complaint resolution or a denied claim or service.
A complaint is anything that you are not happy with except for a denied service or referral for service. An appeal is when you do not agree with how we resolved your complaint or if we denied a service or a request for a service.
The process to submit a complaint or appeal a decision or denial is different depending on the program. To read about the process for your program, see:
- Appeal Process for Basic Health Members
- Appeal and Complaint Process for GA-U (Disability Lifeline) Members
- Appeal and Complaint Process for Healthy Options, SCHIP, and Basic Health Plus Members
If you have questions about grievances and appeals, please contact us. You can call our customer service representatives at 1-800-440-1561 or email us at customercare@chpw.org. If you are hearing or speech impaired, please call TTY 1-866-816-2479 (toll free) or local 206-613-8875.