Grievances and appeals in Kansas
You or your approved representative can file a grievance at any time.
Let us know if we missed the mark
You may want to file a grievance if:
- You're not satisfied with Healthy Blue for any reason.
- You’ve had a problem with the quality of care or service you’ve received from us or network providers.
- You’ve had difficulty getting access to care.
- You feel your rights and dignity have been disrespected.
- You have experienced rude behavior from a provider or a Healthy Blue associate.
- You disagree with the extension of time needed to review your grievance, appeal, or service authorization request.
To appoint a representative to act on your behalf, please provide your written consent. Your authorized representative can be a friend or family member, your doctor, or an attorney.
Directly submit a grievance by logging into the secure member portal - (Coming soon) or the SydneySM Health mobile app. You can find Grievances under the Support tab.
You can appeal within 63 calendar days if your services get denied
If we deny, reduce, or end treatment or services, we’ll send you a Notice of Adverse Determination. It will:
- Explain why we won't pay for the care or services requested by your provider.
- Tell you about your right to appeal our decision.
You, or your authorized representative, can appeal the decision.
Directly submit an appeal by logging into the secure member portal or the Sydney Health mobile app. You can find Appeals under the Support tab.
Request for Appeal Forms
If you’d like to appeal in writing, please use one of the forms below:
Appeal Request Form (Spanish) - (Coming soon)
Authorized Representative Designation Form (English)
Authorized Representative Designation Form (Spanish) - (Coming soon)
Member Appeal Rights (English)
Member Appeal Rights (Spanish) - (Coming soon)