Appeals & Grievances

What AHCCCS and Phoenix Health Plan (PHP) called complaints in the past are now called grievances.

Examples of Grievances:

You're unhappy with the way a person at PHP has treated you.

You don't think you're receiving quality health care.

You can't see your doctor in a timely fashion.

You don't believe a health care treatment met accepted standards.

Any member, or their designated representative, may file a grievance by calling our plan's Grievance & Appeals Department or by writing to the department.

If you have a grievance (complaint) or any type of a problem
with your health care services, it is important that we know your concerns so we can improve our services to you. You may submit a grievance either orally or in writing (by mail or online).

By Mail:
Member Grievances
Phoenix Health Plan
7878 North 16th Street, Suite 105
Phoenix, AZ 85020

Online:
Click on the online grievance form to file a grievance electronically.

By Phone:
(602) 824-3700 or
(800) 747-7997

PHP will contact you within five business days of receipt of your grievance.

Appeals
When PHP makes a decision to deny, terminate, reduce or suspend a service, a letter will be mailed to you stating the reason for the decision. If you do not agree, you can ask us to look at our decision again. This is called an appeal.

Standard Appeal
You may request a standard appeal which will take up to 30 days to resolve. If you request more time or if PHP needs more time to resolve the appeal, the time frame may be extended up to 14 days more.

Expedited Appeal
If your health condition requires a faster response, you may request an expedited appeal. . Expedited appeals will take up to three business days to resolve. If you request more time or if PHP needs more to resolve the appeal, the timeframe may be extended up to 14 days.

If you are already receiving services, you can ask that the service listed in the letter continue while PHP makes a decision.

If you have questions please contact us:

Member Grievances
Phoenix Health Plan
(602) 824-3735 or
(800) 747-7997 EXT. 3735

Submitting an appeal:

By Mail:
Member Appeals
Phoenix Health Plan
7878 North 16th Street, Suite 105
Phoenix, AZ 85020

By Phone:
(602) 824-3735 or
(800) 747-7997 EXT. 3735

For detailed information about Compliant/Grievances and/or Appeals
please review the PHP Member Handbook found here.