Grievances and Appeals
If you are not happy with Carolina Complete Health, or providers, or do not agree with a decision made about your services you can ask for a Grievance or an Appeal. Appeals and grievances are different.
You can contact us by phone or in writing:
- By phone, call Member Services at 1-833-552-3876 (TTY: 711) Monday-Saturday 7 AM - 6 PM EST. After business hours you may leave a message and we will contact you during the next business day. Call Member Services at 1-833-552-3876 (TTY: 711)
- Send a letter or Grievance Form (PDF) electronically by fax to 1-833-318-7256
- Email us: cchgrievancesappeals@carolinacompletehealth.com
- Send a letter or Grievance Form (PDF) by mail to:
Carolina Complete Health
ATTN: Grievance and Appeals
1701 North Graham Street, Suite 101
Charlotte, North Carolina 28206
- You may also file your complaint online by filing out a complaint form.
You can find detailed information about grievances and appeals in our Member Handbook.
What is a Grievance?
A grievance, or complaint, is an expression of a dissatisfaction about any matter other than an “action." If you have a problem with your health plan, care, provider, or services, you can file a complaint or grievance with the plan.
What is a Appeal?
An appeal is a request to review a notice of adverse benefit determination decision by Carolina Complete Health. An adverse benefit determination is the denial, reduction, stopped, or limiting of health services for a member. If the Health Plan makes a decision on health service that you do not agree with, you can ask for an appeal.