What to do if you have a problem, concern, or complaint.
If you have a concern with any part of your health care, healthcare providers or you would like to complain about Banner Medicare Advantage (Banner), please call our Customer Care Center at (833) 516-1007; TTY users call 711. If you need an interpreter, Banner will provide interpretation services to you in any language at no cost to you.
If you need assistance filing your complaint or an appeal a Customer Care Representative can assist you or you may submit an appeal or complaint in writing at the address below.
Banner Medicare Advantage
Attn: Grievance & Appeals Department
2701 E. Elvira Road, Tucson, AZ 85756
Fax: (866) 465-8340
Email: BUHPGrievances&[email protected]
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.
Your request must be filed within 60 calendar days from the date printed on the written coverage decision denial notice. If you miss the appeal filing time frame, and you can show good cause for missing the filing time frame for the reconsideration, Banner will consider the circumstances that prevented the timely filing of your request. The party requesting the extension for good cause, must file a written request and include the reason for the delay.
An appeal (Part C) Reconsiderations or Medication (Part D) Redeterminations can be made over the phone, mail, fax or e-mail.
If you need assistance filing your appeal, call our Customer Care Center.
You may also submit an appeal in writing at the address below:
Banner Medicare Advantage
Attn: Grievance & Appeals Department
5255 E Williams Circle, Ste 2050, Tucson, AZ 85711
Fax: (866) 465-8340
Email: BUHPGrievances&[email protected]
You have the right to get a summary of information about the appeals, grievances, and exceptions that you have filed against Banner. Call our Customer Care Center to request this 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.
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.
You or someone on your behalf such as an appointed representative.
Your grievance or complaint must be filed within 60 calendar days following the incident or issue.
If you need assistance filing your grievance, call our Customer Care Center.
You may also submit a grievance in writing at the address below:
Banner Medicare Advantage
Attn: Grievance & Appeals Department
2701 E. Elvira Road, Tucson, AZ 85756
Fax: (866) 465-8340
Email: BUHPGrievances&[email protected]
If you call us and we cannot resolve your complaint over the phone, we will respond to your complaint within 30 calendar days from the date you file the complaint. If Banner needs more information to resolve the complaint, 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 and explain the reason for the extension and how this delay it is in your best interest. Banner will also provide instructions on how to file a “fast” or expedited complaint if you do not agree with our decision to take the extension.
If you file a written grievance, have a complaint related to quality of care, or ask for a written response, Banner will respond to you in writing.
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, LLC
Phone: (877) 588-1123; TTY users call (855) 887-6668
Hours of Operation: Monday-Friday: 9:00 a.m. - 5:00 p.m. (local time), 24-hour voicemail service is available
Mail: Livanta BFCC-QIO Program
10820 Guilford Road, Suite 202
Annapolis Junction, MD 20701-1105
Fax: Grievances to Livanta at (844) 420-6672
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.
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.
Banner Medicare Advantage must honor your rights as a member of the plan.
You may appoint an individual to act as your representative. With your written authorization, the appointed individual can do the following on your behalf:
A signed authorization form is required by Medicare for an individual to make some requests from Banner Medicare Advantage.
To request an Appointment of Representative (AOR) Form, please call our Customer Care Center
OR print out the form listed below. The form must be signed by you and by the person who you would like to act on your behalf. You must also give us a copy of the signed AOR form. Please see our Contact Us page if you need to ask us a question or would like to send your form to us.
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