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Grievances

What is a “grievance”?

A grievance is a complaint about anything other than benefits, coverage, or payment. You might file a grievance if you had any type of problem with the quality of your medical care, waiting times, or the customer service you receive. You could also file a grievance if you did not think we had responded quickly enough to your request for coverage determination or organization determination, or to your appeal of that determination.
 

Filing a grievance or complaint

You or your appointed representative may file a grievance or complaint in three ways:

Call our Member Services team at:
866-610-2273 (TTY 711).

We're available 8:00 a.m. to 8:00 p.m., 7 days a week.

Mail or fax your written grievance to:

Commonwealth Care Alliance Member Services
Appeals and Grievances
30 Winter Street
Boston, MA 02108
Fax: 617-426-1311

Submit your grievance to Medicare

Submit your complaint directly to Medicare by using their online form* or by callling 800-MEDICARE (800-633-4227). TTY/TDD users can call 877-486-2048. 24 hours a day, 7 days a week.

Contact MassHealth

MassHealth customer service center 800-841-2900,  (TTY: 800-497-4648). Monday - Friday 9 a.m. to 5 p.m.


Quality of care complaints

For quality of care complaints, you may contact Commonwealth Care Alliance (as listed above) or the Massachusetts’ Quality Improvement Organization at 866-815-5440 (TTY 866-868-2289).

Please review your Evidence of Coverage or Member Handbook for more information about grievances.



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