Complaints & Appeals
Mental Health or Substance Abuse
If you have a complaint about mental health or substance abuse care that was denied:
- Call customer service, (800) 247-2583
File an Appeal (also referred to as "grievance")
You may file an appeal right away, but we suggest you make a complaint to customer service first. They can resolve most problems and save you time.
If you decide to file, refer to the table below for necessary steps.
Remember: be very specific with the details of your grievance.
| Grievances Related to... | Should Be Filed By... |
|---|---|
| Emergency or Urgent Servie | Calling (800) 247-2583 |
| All other |
Calling (800) 395-1356
-OR-
|
Reviewal Process and Appeal Decision
- An impartial reviewer will research and resolve your grievance
- The type of grievance filed will determine the duration
The table below illustrates the general timeframe in which you can expect to hear our decision of your appeal:
| if Your review is related to... | WE'll notify you of our decision within... |
|---|---|
| Emergency or Urgent Service | 24 hours of request for review |
| Other | 10 calendar days of request for review |
| Service (not actual health care) | 30 calendar days of request for review |
Unsatisfied with the outcome of first appeal?
You may file a second level appeal, voluntary/independent appeal, at no cost. Write to:
BCBSVT Mental Health 2nd-Level Appeals P.O. Box 186 Montpelier, VT 05601-0186
Still not satisfied?
You may request to have the state's Independent Panel of Mental Health Care Providers review your case. To do so, call:
- (800) 631-7788, or
- (802) 828-2900.
More Info
For specific details about the appeal process, please refer to the "Appeal" section within your Certificate of Coverage.
