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Appeals and Grievances

File a Grievance

A “grievance” is a formal process for filing a complaint. If you are unhappy with your care or the service you’ve received, please let Verda Health Plan of Texas know so we can try to resolve it for you first. If we can’t, or you want to file a formal complaint, please complete the form below. You’ll find more information on the grievance process in your Evidence of Coverage, or call Verda Health Plan of Texas  Member Experience to file a grievance by phone.

Examples of Grievances:
– The quality of care you receive from your doctors
– Office waiting times
– The way you were treated by your doctor or office staff
– The condition of the medical offices
– The treatment you receive from Verda Health Plan representatives
– Involuntary disenrollment issues
– Any other areas, except those related to coverage or payment (see below)

To file a grievance by mail:
Verda Health Plan of  Texas 
Attention: Grievance and Appeal Department 
7755 Center Ave Suite 1200
Huntington Beach, CA 92647
Please note: If your complaint is about a decision related to coverage of care or payment of services, the grievance process does not apply. Instead, you can file an appeal.

For questions about the grievances process or the status of an open grievance, please call: 1- 888-256-5123 (TTY: 711).

Grievance Submission Form

Please use this form to report and describe your grievance. All submissions will be handled with confidentiality and care.

    Member Information

    Grievance Information

    Grievance Involves:

    We’re happy to help today. Call Member Experience:

    1-888-256-5123 (TTY: 711)

    Hours of operations are 8 a.m. to 8 p.m., seven days a week from October 1 to March 31. From April 1 to September 30, hours are 8 a.m. to 8 p.m. Monday through Friday. Messages received on holidays and outside of our business hours will be returned within one business day. Member Experience also has free language interpreter services available for non-English speakers. 

    Data Regarding Grievances & Appeals
    Any Verda Health Plan of Texas member may at any time during their enrollment, request grievance and appeal data orally or in writing by contacting the Member Experience Department.

    Write:
     Verda Health plan of Texas
    c/o Member Experience Department – Attention: A&G 
    7755 Center Avenue Suite 1200
    Huntington Beach, CA 92647

    Call: 1-888-256-5123 (TTY: 711)