Claim Appeal
When a member does not agree with one of our decisions, he or she may go through the steps outlined below.
For mental health and substance abuse appeals:
| step | reference |
|---|---|
| Customer Service Inquiry | pg. 27 |
| Claim Appeal (Grievance) | pg. 27 |
| Voluntary Appeal of First-Level Grievance Decision | pg. 28 |
| Independent Review | pg. 28 |
For all other appeals:
| step | reference |
|---|---|
| Complaint (Inquiry) to Customer Service | pg. 24 |
| Claim Appeal (Grievance) | pg. 25 |
| Voluntary Appeal of Grievance Decision | pg. 26 |
| External Appeal with the State of Vermont | pg. 27 |
