Complaints and Appeals

If you have a complaint, dispute or level of dissatisfaction with Independent Health or one of our affiliated providers, or if you disagree with a coverage decision we have made, you will find assistance here.

Complaints

If you have a grievance, which is any complaint, dispute or level of dissatisfaction you may have with Independent Health or one of our affiliated providers you may:

Print and fill out the Member Complaint Form and mail, email or fax it to:

Independent Health
Benefit Administration
P.O. Box 2090
Buffalo, NY 14231-2090
Email: appeals@independenthealth.com
Fax: (716) 635-3504

Call Member Services at (716) 250-4401 or 1-800-665-1502
(TTY users call 711),
October 1 – March 31: Monday – Sunday, 8 a.m. – 8 p.m.
April 1 – September 30: Monday – Friday 8 a.m. – 8 p.m.

You may also file a complaint directly with Medicare or the Medicare Ombudsman.

Appeals

An appeal is the type of complaint you make if you disagree with a coverage decision we have made. If you have an appeal, you may:

• Complete the Member Appeals Form within 60 days of the initial coverage decision, and mail, email or fax it to:

Independent Health
Benefit Administration
P.O. Box 2090
Buffalo, NY  14231-2090
Email: appeals@independenthealth.com
Fax: (716) 635-3504

You may also call Member Services for appeals process or status questions at (716) 250-4401 or 1-800-665-1502
(TTY users call 711),
October 1 – March 31: Monday – Sunday, 8 a.m. – 8 p.m.
April 1 – September 30: Monday – Friday 8 a.m. – 8 p.m.

• If you need someone else to file a complaint or appeal on your behalf, you will need to fill out an Appointment of Representative Form or provide appropriate legal papers supporting your status as the member’s authorized representative.
  
  Mail, email or fax us this completed form along with the Member Appeal/Complaint Form.

To learn more about how Independent Health manages complaints and appeals, review the Appeals and Quality of Care Complaints Information.

For more information on complaints and appeals please refer to your Evidence of Coverage (EOC) for your Medicare Advantage plan.