Grievances & Appeals

Grievances

What is a grievance?

A grievance is a complaint. You can report a complaint about the quality of care, your health care providers, waiting times, Banner customer service, or any other concerns. 

How to file a grievance?

Start by calling, writing, or faxing us. You, your representative, or your doctor (or other prescriber) can do this. You may call our Customer Care Center if you have questions about filing a grievance.

Write

Banner Medicare Rx
Attn: Customer Care Center
2701 E. Elvira Road
Tucson, AZ 85756
Email: BUHPGrievances&Appeals@bannerhealth.com

If you file a written grievance, have a complaint related to quality of care or ask for a written response, then we will respond to you in writing.

Phone 

Customer Care Center: (844) 549-1859, TTY 711

If you call us and we cannot resolve your complaint over the phone, we will respond to you within 30 calendar days from the date you file the complaint. The longest time Banner Medicare Simple Rx can take to answer a complaint is 30 days. If we need more information or the delay will benefit you, we can take up to 14 days more to respond to your complaint. We will notify you of the need for the 14-day extension, the reason for the extension, how it is in your best interest, and instructions on how to file a “fast” or expedited complaint if you do not agree with our decision to take the extension.

Fax

(866) 849-0338

Quality of Care Grievances

You have two options for filing a quality of care complaint. You may file your quality of care complaint directly with Banner Medicare Advantage and/or with the Quality Improvement Organization (QIO), Livanta.

QIO Contact Information is:
Livanta BFCC-QIO Program 
10820 Guilford Road, Suite 202 
Annapolis Junction, MD 20701 
(877) 588-1123, TTY (855) 887-6668 
Fax: (833) 868-4063

Additional Information

You may also file a complaint or get information directly from Medicare, by calling 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week, TTY/TDD users call 1-877-486-2048. You can also visit the Medicare website.

You have the right to get a summary of information about the appeals, grievances, and exceptions that you have filed against Banner. To request this information, call our Customer Care Center and ask for the Grievance and Appeals Department.

Appeals

What is an appeal?

Banner members have the right to file a “reconsideration” when Banner makes a coverage decision and you are not satisfied with this decision, you can “appeal” the decision. An appeal is a formal way of asking us to review a coverage decision again and possibly change the initial decision in your favor.

You, an appointed representative, or your provider may file an appeal on your behalf.

How to request an appeal?

Start by calling, writing, or faxing us. You, your representative, or your doctor (or other prescriber) can do this. You may call our Customer Care Center if you have questions about filing a grievance.

Write

Banner Medicare Rx
Attn: Customer Care Center
2701 E. Elvira Road
Tucson, AZ 85756
Email: BUHPGrievances&Appeals@bannerhealth.com

Phone 

Customer Care Center: (844) 549-1859, TTY 711

Fax

(866) 849-0338

Additional Information

You may also file a complaint or get information directly from Medicare, by calling 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week, TTY/TDD users call 1-877-486-2048. You can also visit the Medicare website.

You have the right to get a summary of information about the appeals, grievances, and exceptions that you have filed against Banner. To request this information, call our Customer Care Center and ask for the Grievance and Appeals Department.

Related Documents

Medicare Complaint Form     English | Español

Visit our Appointment of Representative page for more information on appointing an individual to act as your representative.