Grievances and appeals
You or your approved representative can file a grievance or appeal.
You or someone on your behalf may file a grievance if:
- You're not satisfied with Wellpoint for any reason.
- You've had a problem with our services or network providers with things like the quality of care they provide.
- 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 Wellpoint associate.
To appoint a representative to act on your behalf, please provide your written consent. Your representative can be a friend or family member, your doctor, or an attorney.
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 your provider asked for.
- Tell you about your right to appeal our decision.
You or your approved representative can appeal the decision.
Learn more about your grievance and appeal rights:
Grievance and appeal rights (English)
Have additional questions?
View your member handbook or chat with a representative.
Save time with live chat
Find answers to all your questions with an Anthem representative in real time. Use our app, Sydney Health, to start a Live Chat.