US Family Health Plan

Timelines for Appeals and Grievances

There are four ways to file an appeal or grievance: online, by fax, by mail, or by phone. The table below lists the turnaround time for US Family Health Plan appeals and grievance submissions.

Type of Inquiry Timeline for Submission Applies to Appeal Review Standard Turnaround Time Expedited Turnaround Time
Payment 90 calendar days from denial date Denied payment for a service already received US Family Health Plan Within 90 calendar days Not available
Service Three calendar days from denial date Denied request for a health service not already received US Family Health Plan Within 30 calendar days Within three business days
Grievance Any time Member dissatisfaction US Family Health Plan Within 30 calendar days Within three business days

  • How to File An Appeal or Grievance