Grievances & Appeals
Your Satisfaction is Our Priority
Your satisfaction is our priority! If you have a problem or complaint, the Customer Service Department can help. The department is available Monday-Friday, 8:00 a.m.-5:00 p.m at (313) 871-2000 or (800) 826-2862. In most cases, the Customer Service Department can resolve your concern. If the department is unable to resolve the problem to your satisfaction, you may file a grievance/appeal.
Grievances and Appeals may be filed for issues that involve:
- The payment of a claim
- The denial of a medical procedure, medication, or durable medical equipment
- Benefits
Members have the right to an independent review by an outside reviewer if you do not agree with a decision we have made for a medically necessary and covered benefit. For more information, either email us at eliminatefwa@thcmi.com or call us at (313) 871-2000 or (800) 826-2862.
For more information regarding the grievance/appeal procedure, contact the Customer Service Department by email or phone. Grievance/Appeal information is also available in your member handbook.
For Commercial Grievance & Appeals procedures please click here.
For the Member Appeal Form please click here.