Grievances or Complaints

Grievances or Complaints

A grievance is a type of complaint you make about us or one of our network providers or pharmacies, including a complaint concerning the quality of your care. This type of complaint does not involve coverage or payment disputes.

What types of problems might lead you to file a grievance?

  • Problems with the service you receive from Customer Service
  • Problems with how long you have to wait at a network pharmacy
  • Having to waiting too long to get your prescriptions filled
  • You believe our notices and other written materials are hard to understand

You have the right to ask Customer Service for a summary of information about the appeals and complaints filed by other members.

Filing a Grievance

Please call Customer Service if you have a complaint. We will work to resolve your complaint over the phone. We will send you a written response if you ask. We have a formal procedure called our Medicare Advantage Grievance and Resolution Process for complaints we cannot resolve over the phone. You can use this formal procedure by sending us your complaint in writing or by asking Customer Service to help you document a complaint.

CALL, MAIL OR FAX:

Blue Cross of Idaho
Medicare Advantage
P.O. Box 8406
Boise ID 83707

Phone: 1-888-494-2583 or TTY 1-800-377-1363, 8 a.m. to 8 p.m., seven days a week.
Fax: 208-331-8829

We will mail an acknowledgement letter to confirm the facts and basis of written grievances. You will receive a written response to your complaint from us within thirty days of the day we receive your grievance. In some instances we will need additional time to address your concern. For questions on the status of an appeal you may call 888-494-2583 (TTY 1-800-377-1363). See your Evidence of Coverage for more information about appeals and grievances.

To file a complaint directly to Medicare, you can do so by filling out the Medicare Complaint Form online.

MORE INFORMATION

For information on how to obtain an aggregate number of grievances, appeals and exceptions with Blue Cross of Idaho Medicare Advantage Plans, please contact Customer Service at 1-888-494-2583 or TTY 1-800-377-1363 8 a.m. to 8 p.m., seven days a week.

Y0010_MK19182_M Accepted 10/1/2018
Last updated 10/01/2018

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Introduction to Medicare