Members Resources

Find tools, information, and other resources to help you get the most out of your benefits.

How to file a Grievance

What is a grievance?

A grievance is a type of complaint that does not involve payment or denial of services by Perennial Advantage or a Contracting Medical Provider. For example, you would file a grievance if:

  • You have a problem with things such as the quality of your care during a hospital stay;
  • You feel you are being encouraged to leave your plan;
  • Waiting times on the phone, at a network pharmacy, in the waiting room, or in the exam room;
  • Waiting too long for prescriptions to be filled;
  • The way your doctors, network pharmacists or others behave;
  • Not being able to reach someone by phone or obtain the information you need; or
  • Lack of cleanliness or the condition of the office.
Who can file a grievance?

A grievance may be filed by any of the following:

  • You may file a grievance
  • Your authorized representative
Why file a grievance?

You are encouraged to use the grievance procedure when you have any type of complaint (other than an appeal) with Perennial Advantage or a Contracting Medical Provider, especially if such complaints result from misinformation, misunderstanding, or lack of information.

Where can a grievance be filed?

You may file a standard grievance over the phone or in writing to:

Colorado: 1-844-788-6959 ( TTY 711), option 6
Ohio: 1-844-788-6986 (TTY 711), option 6

Fax: 1-833-610-2380

Mail:

Perennial Advantage
Appeals and Grievances Department
PO Box 2190
Glen Allen, VA 23058

Call us to expedite an appeal:
Colorado: 1-844-788-6959 ( TTY 711), option 6
Ohio: 1-844-788-6986 (TTY 711), option 6

If you would like you can file a complaint directly to Medicare by filling out the complaint form at https://www.medicare.gov/MedicareComplaintForm/home.aspx.

Can I expedite a grievance?

Yes, you may file an expedited grievance by calling: 1-844-788-6959 ( TTY 711)
 for Colorado or 1-844-788-6986 (TTY 711) for Ohio. Select 
option 6.

Yes. If you disagree with Perennial Advnatage’s decision to extend the timeframe on your organization determination or reconsideration, or Perennial Advantage’s decision to process your expedited request as a standard request. In such cases, you may file an expedited grievance and receive a response within twenty-four (24) hours of receipt.