CMS Reminder: Standard grievances must be resolved within 30 calendar days of receipt. Expedited grievances require resolution within 24 hours. Acknowledgment letter must be sent within 5 business days.
New Grievance Submission

Minimum 50 characters. Be specific about the concern and any immediate impact on the member's health.

📋 Standard
30-day resolution · No immediate health risk
⚡ Expedited
24-hour resolution · Serious health risk or life-threatening

📎
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SLA Deadlines
ACKNOWLEDGMENT DUE
Jan 29, 2025
5 business days from receipt
RESOLUTION DEADLINE
Feb 21, 2025
30 calendar days (standard)
Recent Submissions
Category Reference
Quality: Diagnosis, treatment, medication errors
Access: Appointment delays, provider availability
Billing: Incorrect charges, EOB disputes, copays
Service: Staff behavior, communication issues
Provider: Specific provider conduct complaints
Page Guide
Intake Process
  • Search for member by name or ID first
  • Select correct category to auto-populate subcategories
  • Standard: non-urgent, 30-day window
  • Expedited: serious risk, 24-hour resolution
  • Attach all supporting documents upfront
Expedited Criteria
After Submission
📖 User Manual 🔧 Admin Manual
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