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Grievances

What is a grievance?

A grievance is a complaint about anything other than benefits, coverage, or payment. You would file a grievance if you had any type of problem with the quality of your medical care, waiting times, or the customer service you receive. You would also file a grievance if think we did not respond quickly enough to a request for coverage determination or organization determination, or to an appeal. First Choice VIP Care Plus (Medicare-Medicaid Plan) will respond to your grievance in writing as fast as your situation requires, but no later than 30 calendar days.

Filing a grievance

You or your appointed representative can file a grievance by either :

  • Calling First Choice VIP Care Plus Member Services at 1-888-978-0862 (TTY/TDD 711), 7 days a week, 8 a.m. to 8 p.m.
  • Faxing your request to 1-855-221-0046.
  • Sending a letter to:

First Choice VIP Care Plus
Attn: Appeals and Grievances
P.O. Box 337
Essington, PA 19029

For process or status questions, or to obtain a complete number of AmeriHealth Caritas VIP Care Plus grievances, appeals, and exceptions, please call Member Services at 1-888-978-0862 (TTY/TDD 711), 8 a.m. to 8 p.m., seven days a week. 

For help with complaints, grievances, and information requests, you can also call the Centers for Medicare & Medicaid Services (CMS) at 1-800-MEDICARE (TTY 1-877-486-2048). Or go to the Medicare website and fill out a Medicare complaint form. (Please note: by clicking on this link you will be leaving the First Choice VIP Care Plus website.)

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