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Grievances

If a member has a concern or question regarding the health care services he/she has received, he/she should contact the Member Services department at the toll-free number on the back of their identification card. If the Member Service representative does not resolve the problem to the member's satisfaction, the member has the right to file a grievance.

What is a grievance?

A grievance expresses dissatisfaction about any matter related to all services offered by AmeriHealth Caritas VIP Care Plus (Medicare-Medicaid Plan). A grievance may be filed about such things as the quality of the care the member receives from AmeriHealth Caritas VIP Care Plus; a provider; rudeness from a AmeriHealth Caritas VIP Care Plus, employee or a provider's employee; a lack of respect for their rights by AmeriHealth Caritas VIP Care Plus; or any service or item that did not meet accepted standards for health care during a course of treatment.

How does a member file a grievance?

To file a grievance, the member, or the member's physician or other representative, may call Member Services at 1-888-667-0318 (TTY 711), 8 a.m. to 8 p.m., 7 days a week.

Or write to:
AmeriHealth Caritas VIP Care Plus
Medicare Compliance
Attn: Member Appeals, Grievances and Complaints
P.O. Box 337
Essington, PA 19113

Additional grievances and appeals information can be found in the Provider Manual (PDF).

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