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 grievance with PHI removed.
Prior to filing a grievance with URAC, we strongly recommend that you contact the individual company to file your grievance and allow the company an opportunity to resolve the matter.
URAC accepts grievances that are in writing through this webpage and contains the complainants' contact information which may be shared with accredited organizations. URAC may contact you to clarify the facts surrounding your grievance, but is not obliged to do so.
URAC will not disclose or share information regarding any specific outcome of a grievance or grievance investigation, however may collect statistical data for tracking purposes.
URAC has no authority to resolve disputes between any complainant and a URAC-accredited company based on a benefit determination or the payment of such benefits such as (but not limited to) benefits that are not a covered benefit under your policy, your insurance has lapsed or coverage was terminated, disputes with issues such as premiums, deductibles, co-pays, reimbursement rates, in-network and out of network payments, claims or disputes, etc.
URAC can only investigate a URAC-accredited company for an issue that is related to URAC’s standards for which the company is accredited.
In the event URAC contacts you regarding your grievance and no response is received within three (3) business days, URAC will close the grievance for administrative purposes and no further action will be taken by URAC.
By submitting this grievance, you authorize URAC to release your name and other identifying information to the URAC-accredited company you have identified, unless you have requested to remain anonymous to the accredited company. Please note that you may be contacted directly by the accredited company for additional information to facilitate investigation as is deemed necessary.
By submitting this grievance to URAC, you have granted consent to view/disclose such information during the course of the investigation to the accredited client. Additionally, you will not hold URAC liable for any disclosure of information contained in your grievance.
You may have other recourse for filing a grievance if the issue is not one that can be addressed by URAC such as your state insurance or health agency (see http://www.naic.org/state_contacts/sid_websites.htm) (National Association of Insurance Commissioners).
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 grievances. If you do not agree, your grievance will not be submitted.
