Complaints and grievances
Have a concern or complaint about our services? Let us know, and we’ll work to resolve the issue promptly.
File a suggestion, appeal, complaint, or grievance
You have the right to file a suggestion, appeal, complaint or grievance about:
- APWU Health Plan
- A healthcare service
- A healthcare provider or professional
All suggestions are shared with the appropriate staff and departments. All complaints are investigated and resolved by the Member Service Representative. Your provider can file a complaint for you if you give the provider your consent in writing to do so.
How to file a complaint by phone, email or mail
Response timeframe: 30 days
How to file an urgent or expedited appeal/complaint by mail
If your complaint is regarding medical care or treatment that is urgent and requires an expedited response, please follow these directions:
High Option
APWU Health Plan
P.O. Box 8660
Elkridge, MD 21075
Consumer Driven Option
UnitedHealthcare Appeals
P.O. Box 740816
Atlanta, GA 30374-0816
Response timeframes
Urgent/expedited
pre-service claim:
72 hours
Pre-service claim
a claim requiring pre-approval as a condition of coverage:
15 business days
Post-service claim
a claim for services that have already been provided:
30 business days
Members (or designees) have the right to file a grievance or appeal when they disagree with APWU Health Plan’s decision not to authorize services or not to pay for a claim.
Appeals must be received in writing and submitted within 180 days of the original claim determination. Additional information on the appeals process may be found on our website or in the official Health Plan brochure, Section 8.
Your comments and suggestions are important to us as we strive to improve the quality of service and care we provide to our members.