Grievances and Appeals
As a Community Health Plan member, you have the right to file a complaint or to appeal a complaint resolution or a denied claim or service.
A complaint is anything that you are not happy with except for a denied service or referral for service. An appeal is when you do not agree with how we resolved your complaint or if we denied a service or a request for a service.
The process to submit a complaint or appeal a decision or denial is different depending on the program. To read about the process for your program, see:
- Appeal Process for Basic Health Members
- Appeal and Complaint Process for GA-U (Disability Lifeline) Members
- Appeal and Complaint Process for Healthy Options, SCHIP, and Basic Health Plus Members
- Appeal and Complaint Process for Washington Health Program Members
If you have questions about grievances and appeals, please contact us. You can call our customer service representatives at 1-800-440-1561 or email us at customercare@chpw.org. If you are hearing or speech impaired, please call TTY 1-866-816-2479 (toll free) or local 206-613-8875.