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Grievances and appeals

If a member has a concern or question regarding the health care services he/she has received, he/she should contact the Member Services department at the toll-free number on the back of their identification card. If the Member Service representative does not resolve the problem to the member's satisfaction, he/she has the right to file a grievance.

What is a grievance?

A grievance expresses dissatisfaction about any matter related to the services offered by AmeriHealth Caritas VIP Care (HMO SNP). A grievance may be filed about such things as the quality of the care the member receives from a AmeriHealth Caritas VIP Care provider, rudeness from a AmeriHealth Caritas VIP Care employee or a provider's employee, a lack of respect for their rights by AmeriHealth Caritas VIP Care or any service or item that did not meet accepted standards for health care during a course of treatment.

How does a member file a grievance?

To file a grievance, the member, or the member's physician or other representative, may call Member Services at 1-866-533-5490, TDD/TTY 711, or write to:

AmeriHealth Caritas VIP Care
Medicare Compliance
Attn: Member Appeals, Grievances and Complaints
P.O. Box 337 Philadelphia, PA 19113

Additional grievances and appeals information can be found in the Provider Manual (PDF).

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