Appeals & Grievances

US Family Health Plan Appeals & Grievances

If you disagree with a health determination made by CHRISTUS Health Plan (for example, being refused service or coverage), you can file an appeal. An appeal is a formal request to have the decision reviewed. An expedited appeal can be made if you or your physician believes that waiting could place the beneficiary’s life, health or ability to regain function in jeopardy.

If you are unhappy with service and want to make a complaint, you can file a grievance. Examples of grievances include if someone is rude to you, you have a long wait on the phone, or you experience poor quality of services from a provider.

File an Appeal or Grievance


CHRISTUS Health Plan
Attn: Appeal and Grievance Dept.
PO Box 169009
Irving, TX 75016

  • Appeals must be made in writing, but grievances can also be made over the phone by calling 1-844-282-0380.

Timelines for Appeals and Grievances

The table below lists the turnaround time for US Family Health Plan appeals and grievance submissions.

Responsive Table
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

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Last Updated: 2/23/17