Appeals and Grievances

Appeals & Grievances Contact Information

For questions about the appeals and grievances process or the status of an open appeal or grievance, please call: 1-888-256-5123 (TTY: 711).

Calls to this number are free, 8 a.m. to 8 p.m., 7 days a week (except Thanksgiving and Christmas) from October 1 through March 31, and Monday to Friday (except holidays) from April 1 through September 30.

Data Regarding Appeals & Grievances

Any Verda member may at any time during their enrollment, request appeal and grievance data, including aggregate number of Grievances, Appeals, and Exceptions, orally or in writing by contacting the Member Experience Department.

Write:
Verda Health Plan of Texas
c/o Attention: A&G Department
7755 Center Ave., Suite 1200
Huntington Beach, CA 92647
Call: 1-888-256-5123 (TTY: 711)
Fax: 1-714-845-9839

The process for coverage decisions and appeals can be found in your Evidence of Coverage (Member Handbook). This is the process you use for issues such as whether something is covered or not and the way in which something is covered. Please refer to your Evidence of Coverage (Member Handbook) for a full description of the process by visiting our Forms & Resources.

Download this form to file a formal complaint or appeal regarding any aspect of the medical care or service provided to you. Your complaint or appeal may be in reference to your medical or pharmaceutical benefits.

You may also submit feedback or complaints about your Medicare Advantage Health Plan directly to Medicare by submitting a complaint through www.medicare.gov or by calling 1-800-Medicare. When submitting a marketing complaint, it is important to provide an agent or broker name, if possible.