A grievance is a complaint you file with Granite Alliance. If you contact us with a complaint, we will file a grievance on your behalf. Your grievance (or complaint) could be about any of the following types of items:
You are unhappy with the quality of care you received
You believe someone did not respect your privacy or shared your information
You are unhappy with the customer service you received
You experienced long wait times for the pharmacist or on the phone with Customer Service
You are unhappy with the service received at or cleanliness of the pharmacy
You believe the information we provided was hard to understand
You believe we were not timely in our decision-making process
Any other type of issue that may cause you concern
If you are looking for approval on coverage of a medication, that would be considered a coverage determination. If you have already requested a coverage determination and it was denied, you are then able to submit an appeal or a redetermination. These processes themselves would not be considered a grievance.
You have the right to file a complaint up to 60 days after the event has occurred. There are several ways that you can contact us to file a grievance. You can also use these methods if you wish to request an aggregate number of grievances, appeals, and exceptions filed with Granite Alliance.
When you contact us to file your grievance, either via phone or in writing, please have the following information available:
Call Us! 1-855-586-2573 (TTY: 711)
Hours of Operation: 24 hours a day, 7 days a week
Email: GAICHelp@primetherapeutics.com
Mail the Request:
Granite Alliance Insurance Company
P.O. Box 64810
St. Paul, MN 55164
Fax: 1-888-656-8099
Once we receive your complaint, we will review and address it as quickly as possible. You will receive a response no later than 30 days after we have initially received your complaint. We may ask for an additional 14 days if we believe we need to gather more information to best address your concerns.
Once we have completed our review, you will be notified of the resolution either by telephone or in writing.
Once we receive your complaint, we will review and address it as quickly as possible. You will receive a response no later than 30 days after we have initially received your complaint. We may ask for an additional 14 days if we believe we need to gather more information to best address your concerns.
Your Evidence of Coverage includes additional information about the Grievance process. The information can be found in Chapter 6. The Evidence of Coverage can be accessed from our Plan Documents and Forms page.
You also have the option to file a complaint with CMS using the
Last Updated Date: 12/04/2024
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