| PLAN |
Appeals & Grievance Information
UPDATED as of 4/24/18
|
Mail / in-person
Address to Request and or File Appeals
|
Phone/Fax/Email to Request Appeal (UPDATED as of 4/24/18) |
| Aetna Better Health |
Appeal info here.
Member handbook here.
|
Aetna Better Health
Grievance Systems Manager
55 West 125th Street, Suite 1300
NYC, NY 10027 |
TEL: 855-456-9126
FAX: 855-264-3822
|
| Agewell |
Appeal info here.
Member handbook here.
|
AgeWell New York
Appeals and Grievances Department
1991 Marcus Avenue. Suite M201
Lake Success, NY 11042 |
TEL: 866-586-8044
|
| Archcare Community Life |
Member handbook here. |
Appeals & Grievances Department, 33 Irving Place, 11th Floor, New York, NY 10003 |
TEL: 855-467-9351
FAX: 212‑524‑5163
|
| Centers Plan for Healthy Living |
Grievance & Appeals Appeal info here
Where to request appeals here.
Member handbook here (4 languages) (3/2017)
|
Centers Plan for Healthy Living Advantage Care HMO
75 Vanderbilt Avenue
Staten Island, NY 10304
Attention: Grievance and Appeals Department
|
TEL: 855-270-1600 ext 3792
FAX: 347-505-7089
E-mail: GandA@centersplan.com
|
| ElderServe Health Inc. |
Corporate Policy – MLTC – Appeals from Adverse Determinations, undated. Corporate Policy – MLTC – Grievance Procedure, undated. |
Quality Department 80 West 225 St, 2nd floor, Bronx, 10463
|
TEL: 800-370-3600
FAX: 888-341-5009 (To Pamela Baez)
|
| Extended MLTC |
Member Handbook Effective 5/01/2018 |
Extended MLTC, LLC, 21 Penn Plaza 360 West 31st Street, Suite 304, New York, NY 10001 ATTN: Membership Services Department. |
TEL: 855-299-6492
FAX: 718-761-5948
|
| Fidelis Care at Home |
Corporate Policy – MLTC – Appeals from Adverse Determinations, last revised August 22, 2011. Appeals information begins on p. 8.
Corporate Policy – MLTC – Greivance Procedure, p. 1
Member handbook here.
|
Fidelis Care at Home, 95-25 Queens Boulevard, Rego Park, New York 11374 |
TEL: 800-688-7422
FAX: 716-803-8727
|
| Guildnet MLTC |
Corporate Policy – MLTC – Appeals from Adverse Determinations, dated Dec. 21, 2005.
Corporate Policy – MLTC – Grievance Procedure, dated July 2005.
Corporate Policy – MLTC – Appeals of Grievances, dated July 2005.
|
Guildnet MLTC
250 West 64th Street
New York, NY 10023
|
TEL: 800-932-4703
EMAIL: gnprovrel@jgb.org
|
| HealthPlus MLTC (Empire BlueCross Blue Shield) |
Corporate Policy – MLTC – Appeals of Adverse Determinations, last revised March 24 , 2011
Corporate Policy – MLTC – Grievance Procedure, last revised Dec. 28, 2011.
|
Grievance and Appeals Empire BlueCross BlueShield HealthPlus P.O. Box 1198 New York, NY 10116 |
TEL: 800-950-7679
FAX: 866-495-8716
|
| HomeFirst, Inc. MLTC (ElderPlan) |
Member Handbook for Appeals and Complaints
Member Handbook – General (English)
|
Elderplan Attn: Appeals & Grievances Department 745 64th Street, Brooklyn, N.Y. 11220
|
TEL: 877-771-1119
FAX: 718-765-2027
|
| Independence Care System |
Member handbook available in English and Spanish. (2012)
|
Director of Advocacy Independence Care System 257 Park Ave. South, 2nd floor New York, N.Y. 10010 |
TEL: 877-427-2525
FAX: 212-584-2555.
|
| Integra MLTC |
Member Handbook English
Member Handbook Appeals and Complaints (05/01/2018)
|
Member Services Integra MLTC, Inc. 1981 Marcus Avenue, Suite 100 Lake Success, NY 11042 |
TEL: 855-661-0002 |
| MetroPlus |
Appeals and Grievance info starts on page 19 of the member handbook – English and Spanish (2014) |
MetroPlus Health Plan Managed Long Term Care 160 Water Street, 3rd Floor New York, NY 10038 |
TEL: 800-303-9626
FAX: 212-908-5282
|
| Montefiore Diamond Care (Bronx) |
Member Handbook |
Montefiore Diamond Care Grievances and Appeals Department Box 500 200 Corporate Blvd. South, Suite 200 Yonkers, NY 10701 |
TEL: 855-556-6683
FAX: 915-457-9516
|
| RiverSpring at Home |
Member Handbook (English) |
RiverSpring Star, ATTN: Appeals & Grievance Dept. 94 W 225th St. 2nd Floor; Bronx, NY 10463 |
TEL: 800-580-7000
FAX: 888-810-0215
|
| Senior Health Partners (Healthfirst ) |
Member Handbook |
Senior Health Partners Attn: Appeals and Grievances PO Box 5166 New York, NY 10274-5166 |
TEL: 800-633-9717
FAX: 646-313-4603
|
| Senior Whole Health of New York – MLTC |
Member handbook available here.
|
Senior Whole Health of New York Quality Improvement Department
58 Charles Street
Cambridge, MA 02141 |
TEL: 877-353-0185 |
|
UnitedHealthcare Personal Assist
|
Member handbook beginning page 30. Spanish. (2014)
|
UnitedHealthcare Community Plan Attn: UM Appeals and Grievance Coordinator P.O. Box 31364 Salt Lake City, UT 84131-0364 |
TEL: 877-512-9354
|
|
|
| VillageCare Max |
Member handbook beginning page 29. |
VillageCareMAX Appeals 112 Charles Street New York, NY 10014
|
TEL: 800-469-6292
FAX: 212-337-5711
|
| VNSNY Choice MLTC |
Member handbook beginning page 58.
|
VNSNY CHOICE
MLTC Grievance and Appeals
P.O. Box 445
Elmsford, NY 10523 |
TEL: 800-469-6292
EMAIL: grievence.appeals@vnsny.org
|
| WellCare Advocate MLTC |
Appeals information available here. Member handbook here. |
WellCare Appeals Department
P.O. Box 31384
Tampa, FL 33631-3384 |
TEL: 877-395-4282
FAX: 866-201-0657
|
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