Grievances

What is a Grievance?

A grievance is a way for you to file a formal complaint if you are dissatisfied with any aspect of the quality of care or services you receive from a doctor, staff member, pharmacy, or our plan. You can file a grievance if you disagree with a coverage decision that we made about a medical service or drug, or if you were unhappy with the quality of care received from a doctor or pharmacy. You can also file a grievance if you requested an expedited appeal decision but we reviewed it as a standard appeal.

A grievance will not change the outcome of a coverage decision or a payment dispute, but your expression of dissatisfaction will remain on file with us and allow us to use your concerns to when updating processes and policies.

How to File a Grievance

You or your appointed representative can file a grievance for you in the following ways.

  • Call Member Services at 1-855-833-8125
  • Send a fax to 617-897-0805
  • Send a letter to:

    Boston Medical Center HealthNet Plan Senior Care Options
    Attention: Member Grievances
    529 Main Street, Suite 500
    Charlestown, MA 02129

You can also submit your complaint directly to Medicare. You can either use their online form at Medicare.gov*, or you can call 1-800-MEDICARE (1-800-633-4227) to speak with a representative. TTY/TDD users can call 1-877-486-2048, 24 hours a day, 7 days a week.

*When you click this link, you will leave our website.


H9585_117_092015_Approved
Last Updated 11/23/16