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Insurance Plan Grievance & Appeals Procedures
If you need to file a complaint or appeal regarding insurance coverage decisions, claims denials, or prior authorization disputes, you should contact your insurance plan directly using their official grievance procedures. Each insurance plan has specific forms, timeframes, and processes for handling these types of concerns.
For practice-related concerns such as appointment scheduling, wait times, staff interactions, or quality of care issues, please contact our office directly at (760) 891-4687 or speak with any staff member during your visit.
Below are the official grievance and appeals procedure links for the insurance plans we contract with:
Anthem Blue Cross PPO: https://www.anthem.com/ca/complaints-grievances
United Healthcare: (Medicare Advantage Plans/Part D plans) https://www.uhc.com/communityplan/learn-about-medicare/appeals-grievances-process (Commercial plans: contact customer support number on your insurance card)
Blue Shield of California: https://www.blueshieldca.com/en/home/help-and-support/grievance-process
Cigna PPO: https://www.cigna.com/individuals-families/member-guide/appeals-grievances
Tricare: https://www.tricare.mil/complaint
Medicare Part B: https://www.medicare.gov/providers-services/claims-appeals-complaints
Greater Tri-Cities IPA plans: Patients should file grievances directly with their health plan using the procedures listed above or the number on their insurance card.