File a Grievance

URAC accepts complaints that are in writing through this webpage and contains the complainants' contact information which may be shared with accredited organizations unless the complainant desires to remain anonymous. To file a grievance against a URAC-accredited organization, please fill out the form below. Required fields are marked with an asterisk (*).

First Name *

Last Name *

Phone

Email Address *

Please select the category that best describes you. *

Would you like to remain anonymous to the Accredited Organization? *

Accredited Organization Name *

Accredited Organization City/State *

Accredited Organization Website

The website of the organization you wish URAC to contact is very important and will help us in our investigation. (Example: www.bluescreen.com).

Date of Occurrence *

Accreditation Type

If you find a URAC seal on the website, enter the information just below the circle of the seal. This indicates the type of accreditation held by the organization. (100 character limit)

Type of Concern (check all that apply)

Access

Authorization

Accreditation / Seal Misrepresentation

Service Quality

Service Timeliness

Staff Qualification

Other Grievance

PLEASE DO NOT submit any personally protected health information (PHI), such as social security number, date of birth, diagnosis, etc., on this website. Protected health information (PHI) is any information about health status, provision of health care, or payment for health care that can be linked to a specific individual. Submitting PHI to URAC is strictly prohibited. Should URAC receive PHI, it will not be accepted and you will be contacted with a request to re-submit your complaint with PHI removed. Additional information about what is PHI can be found here: http://www.hhs.gov/answers/hipaa/what-is-phi/index.html

Please describe (max. 500 words) *

Prior to filing a grievance with URAC, we strongly recommend that you contact the individual organization to file your complaint and allow the organization an opportunity to resolve the matter.

URAC may contact you to clarify the facts surrounding your grievance but is not obliged to do so.

URAC has no authority to resolve disputes between any complainant and a URAC-accredited organization based on a benefit determination or the payment of such benefits.

URAC will not disclose or share information regarding any specific outcome of a grievance or complaint investigation, however may collect statistical data for tracking purposes.

By submitting this complaint, you authorize URAC to begin the investigation including sharing your contact information unless you have elected to remain anonymous. URAC and/or the accredited organization may need to contact you directly for additional information to facilitate the investigation as is deemed necessary. You agree that you will not hold URAC liable for any disclosure of information contained in your complaint.

URAC can only investigate a URAC accredited organization for an issue that is related to URAC’s program for which the organization is accredited. If you have a complaint that is not in scope with the accreditation, you may have other recourse for filing a complaint with your state insurance or health agency (see http://www.naic.org/state_contacts/sid_websites.htm) (National Association of Insurance Commissioners). URAC cannot advise you on your alternative recourse if URAC cannot evaluate your grievance.

I have read and agree to the information, terms and conditions as indicated on this website. I further understand that URAC expressly prohibits the submission of protected health information and reserves the right to change terms and conditions without further notice and/or as required by law. Checking this box indicates my agreement to these terms and conditions and I understand it is required for submission of complaints. If you do not agree, your grievance will not be submitted.

Check here if you agree and want to submit your grievance. *

To file a complaint against URAC please fill out the form below.

First Name

Last Name

Phone

Address Line 1

Address Line 2

City

State

Zip

Please check one box indicating the type of problem you are having

Accreditation Services

Publications

Education (URAC workshop or conference)

Staff response (phone manner, personal concern, etc.)

URAC's website

Other…

Issue

Please briefly explain your concern and/or complaint (500 words or less)

DO NOT submit any personally protected health information (PHI) on this website. Protected health information (PHI) is any information about health status, provision of health care, or payment for health care that can be linked to a specific individual. Submitting PHI to URAC is strictly prohibited. Additional information about PHI can be found here: http://www.hhs.gov/answers/hipaa/what-is-phi/index.html. Should URAC receive PHI, it will not be accepted and you will be contacted with a request to re-submit your complaint with PHI removed.