How to File an Inquiry, Complaint or Grievance/Appeal

The plan allows you to initiate an inquiry, complaint or grievance/appeal in the following ways:

1. By Mail: For requests relating to the Managed Care Review Program (inpatient hospital admissions, certain outpatient diagnostic and surgical procedures, durable medical equipment, home health care, physical and occupational therapy, and chiropractic and osteopathic manipulation), direct the request to: UniCare State Indemnity Plan, Appeals Review P.O. Box 2011, Andover, MA 01810-0037.
   
   Send all other requests to UniCare State Indemnity Plan, Appeals Review, P.O. Box 2075 Andover, MA 01810-0037.



2. By Fax: Fax a written request to the Plan at (978) 474-5165.



3. By Telephone: Call the Plan at (800) 442-9300 to submit your request verbally to a customer service representative.



4. In Person: To file an appeal in person, please contact the Plan at (800) 442-9300 to arrange an appointment.