Filing a Grievance

We hope our members will always be happy with us and our providers. But if you are not happy, please let us know. This includes if you do not agree with a decision we have made about your care. A grievance is an expression of dissatisfaction about any matter other than a Proposed Action.

A proposed action is when Peach State:

• Denies the care you want.
• Decreases the amount of care.
• Ends care that has already been approved.
• Denies payment for care. You may have to pay for it.

A Member Grievance can be filed if or when:

• A Member is dissatisfied with a provider services or care
• Provider and/or staff have behavior that is inappropriate or discourteous
• Provider has limited availability to members
• Your appeal was not processed timely

You have the right to file a Grievance. We cannot treat you differently because you have filed a grievance. Your benefits will not be affected.

To file a Grievance, you can:

Call Member Services at (800) 704-1484, TDD/TTY (800) 659-7487. They can also help you if you need this information translated.

Or write us a letter telling us why you are not happy. Be sure to include:

• Your first and last names.
• Your Peach State ID card number.
• Your address and telephone number.

Mail the letter to:
Peach State Health Plan
Quality Improvement Coordinator
3200 Highlands Parkway SE
Suite 300
Smyrna, GA 30082

If you would rather have someone speak for you, let us know. Another person can act for you.