Total Health Care

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 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 Medicaid Grievance & Appeals procedures please click here.