What is a grievance?
A grievance is a complaint about anything other than benefits, coverage, or payment. You would file a grievance if you had any type of problem with the quality of your medical care, waiting times, or the customer service you receive. You would also file a grievance if you did not think we had responded quickly enough to your request for a coverage determination or organization determination or to your appeal. AmeriHealth Caritas VIP Care Plus will respond to your grievance in writing as quickly as your situation requires, but no later than 30 calendar days.
Please note: Grievances related to Part D must be filed within 60 calendar days after you had the problem you want to complain about. You may file a grievance for all other issues at any time.
Filing a grievance
You or your appointed representative can file a grievance by:
- Calling our AmeriHealth Caritas VIP Care Plus Member Services team at 1-888-667-0318 (TTY/TDD 711), 8 a.m. to 8 p.m., seven days a week.
- Faxing your request to 1-855-221-0046.
- Sending a letter to:
AmeriHealth Caritas VIP Care Plus
Attn: Appeals and Grievances Department
P.O. Box 337
Essington, PA 19029
For process or status questions, or to obtain a complete number of AmeriHealth Caritas VIP Care Plus grievances, appeals, and exceptions, please call Member Services at 1-888-667-0318 (TTY/TDD 711), 8 a.m. to 8 p.m., seven days a week.
For help with complaints, grievances, and information requests, you can also call the Centers for Medicare & Medicaid Services (CMS) at 1-800-MEDICARE (TTY 1-877-486-2048). Or go to the Medicare website and fill out a Medicare Complaint Form. (Please note: by clicking on this link you will be leaving the AmeriHealth Caritas VIP Care Plus website.)