You have the right to file a grievance or complaint and appeal a decision made by us. Use the links below to review the appropriate appeal document, which presents important information on how to file, timeframes and additional resources.
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Grievances and Appeals
First Level Complaint Appeal Rights
Important information about your rights and how to file a complaint appeal.
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First Level Grievance Appeal Rights
Important information about your rights and how to file a grievance appeal.
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Final Level Grievance Appeal Rights
Important information about your completed final level of internal review and other resources to help you.
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Medicaid Grievance and Appeals Rights
Important information about your rights and other resources to help you.
HARP Grievance and Appeals Rights
Important information about your rights and other resources to help you.
Medicare Appeal Information
Important information about your rights and other resources to help you.
GHI Hospital and Medical Claim Appeal Information
Important information about your rights and other resources to help you.
HIP Claim Appeal Information
Important information about your rights and other resources to help you.
NYS GHI Dental Claims Appeal Information
Important information about your rights and other resources to help you.
If you have any questions or need help reading or understanding these documents, please call EmblemHealth Customer Service.
KNOW YOUR RIGHTS
Member Rights and Responsibilities
Understanding your rights and responsibilities as a plan member can help you and us make the most of your membership.
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Consumer Protections
Learn about certain protections which are effective with dates of service on or after March 31, 2015, as well as what to do if you feel you have received a surprise bill.
