Banner Medicare Advantage Dual HMO D-SNP and Banner – University Family Care/ALTCS (B – UFC/ALTCS) members have the right to appeal health plan decisions. You can file an appeal when the health plan makes a coverage decision you are not satisfied with. An appeal is a formal way of asking us to review a coverage decision again and possibly change the initial decision in your favor.
You, an appointed representative, or your provider may file an appeal on your behalf.
Your request must be filed within 65 calendar days from the date printed on the written coverage decision denial notice. If you miss the appeal filing time frame, and you can show good cause for missing the filing time frame for the appeal, the health plan will consider the circumstances that prevented the timely filing of your request. The party requesting the extension for good cause, must file a written request and include the reason for the delay.
Appeals can be made over the phone, mail, fax or e-mail. If you need assistance filing your appeal, call our Customer Care Center, 8 a.m. to 8 p.m., seven days a week for Banner Dual appeals or 833-318-4146, TTY 711, 7:30 a.m. to 5:00 p.m., Monday through Friday, for B – UFC/ALTCS appeals. You may also submit an appeal in writing at the address below:
Banner Medicare Advantage Dual HMO D-SNP
Banner – University Family Care/ALTCS
Attn: Grievance & Appeals Department
5255 E Williams Circle, Ste 2050, Tucson, AZ 85711
Fax: 866-465-8340
Email: BUHPGrievances&[email protected]
You have the right to get a summary of information about the appeals, grievances, and exceptions that you have filed with us. To request this information, call our Customer Care Center, for Banner Dual or 833-318-4146, TTY 711, for B – UFC/ALTCS and ask for the Grievance and Appeals Department.