If you are not satisfied with the quality of service you have received from us, or at a doctor’s office, you have the right to make a formal complaint. It can be about long waiting times or concerns about a medical treatment. This is called a grievance. It will not affect your coverage and benefits.
A CareAdvantage Navigator will try to resolve your complaint over the phone. If your complaint is not resolved, you can file a grievance.
You can use our formal process for communicating your complaint as a grievance.
Your 2012 CareAdvantage Evidence of Coverage (pages 181 - 183) has descriptions of problems that can be reported as a complaint.
Note: For full program benefits and description, please consult the CareAdvantage Evidence of Coverage/Member Handbook, located in the Resources section.
H5428_CA_4001_12_EN Pending CMS Approval (Updated 02/22/2012)