Grievances

Back To Grievances and Appeals

What is a Grievance?

A grievance is a complaint when you are not happy with the care or services you are getting, or you have concerns with how a doctor, or their staff is treating you. Examples of grievances are:

  • Service issues
  • Transportation issues
  • Quality of care issues
  • Provider office issues

How do I file a complaint? 

Call our Customer Care Center if you have a specific grievance or dissatisfaction with any aspect of your care. Our Customer Care Center will assist you in filing your complaint. B – UFC/ACC also provides interpretation services in any language at no cost to you. 

You may file your grievance in writing by mailing it to:

  • Banner – University Family Care/ACC
    Attention: Grievances and Appeals
    5255 E Williams Circle, Ste 2050
    Tucson, AZ 85711

If B – UFC/ACC denies a requested service, you will receive a letter called the Notice of Adverse Benefit Determination (NOABD). You can also file a complaint regarding this letter for a denial of service by B – UFC/ACC. If we cannot take care of your concern with the adequacy of the Notice of Adverse Benefit Determination letter or have not effectively resolved the issue, you have the right to contact:

  • AHCCCS Office of Medical Management
    Phone: (602) 417-4000
    Email: [email protected]
    Write: Arizona Care Cost Containment System (AHCCCS)
    ATTN: Division of Health Care Management
    701 E. Jefferson Street, MD 8500
    Phoenix, AZ 85034

How long does it take to investigate the complaint?

Your grievance will be reviewed, and a response will be provided no later than ninety (90) days from the date the complaint was filed.

SMI Grievance and Request for Investigation Process

If you have been found to have a Serious Mental Illness (SMI) and feel that your rights have been violated, you have the right to file a grievance and ask for an investigation. Members, their legal guardians, or authorized representatives can file a SMI grievance and ask for an investigation if:

  • They are an adult who has been found to have a SMI.
  • If the services received by the member are behavioral health services.
  • The member believes their rights have been violated;
  • The member believes they have been abused or mistreated by a provider or their staff; or
  • The member believes that they have been subjected to illegal, dangerous, or inhumane treatment.

Members, their legal guardians, or authorized representatives have 12 months from the time their rights were violated to file an SMI grievance and ask for an investigation. SMI Grievances and requests for an investigation can be filed orally or in writing to:

Banner – University Health Plans
Attention: Grievances and Appeals
5255 E Williams Circle, Ste 2050
Tucson, AZ 85711
(800) 582-8686, TTY 711

Forms to file an SMI Grievance and request for an investigation are available at the above address or at any contracted behavioral health provider.

Once a member's SMI Grievance and request for an investigation is received, B – UFC/ACC will respond in writing within five days and will explain how the grievance and request for an investigation will be handled.

Grievances and requests for investigations regarding physical or sexual abuse, or death should be reported directly to AHCCCS at:

AHCCCS
Attention: Behavioral Health Grievances and Appeals
701 E. Jefferson Street
Phoenix, AZ 85034
Phone: (602) 417-4000
Fax: (602) 252-6536, TTY 711