Apelaciones y quejas | Allwell de MHS Health Wisconsin

Appeals and Grievances

 

Your satisfaction is our priority – so if you are having a problem getting the care or services you desire, we want to talk with you. Please call us and we will do everything we can to resolve your concern. If after we talk you are not satisfied; please reference the information below regarding your appeals and grievances rights.
 

Appeals (Parts C & D)
Grievances (Parts C & D)

Appointing a Representative – Instructions & Form

People who want to represent a member can be appointed or authorized by the member.

A member can authorize anyone (like a relative, friend, advocate, an attorney, or a doctor) to act as his or her representative and file an appeal or grievance on his or her behalf.

A representative (or surrogate) can also be authorized by the court or act on behalf of the member in accordance with State law to file an appeal or grievance for an enrollee. A surrogate could include, but is not limited to, a court appointed guardian, an individual who has Durable Power of Attorney, or a health care proxy, or a person designated under a health care consent statute.

How to authorize a representative:

  • The member must sign, date, and complete a representative form.
  • The person acting on behalf of the member must sign, date and complete the same form. 
  • Print and complete the Appointment of Representative form. (By clicking on this link you will be leaving the Wellcare por Allwell website.) If a member is incapacitated or legally incompetent a surrogate is not required to submit an Appointment of Representative Form. The surrogate will need to give Wellcare por Allwell copies of the legal papers supporting his or her status as the member’s authorized representative. Wellcare por Allwell requires a copy of the completed and signed Appointment of Representative Form to process an appeal filed by the member’s representative. The form will be valid during the entire appeal/grievance process. The Appointment of Representative Form is valid for one year from the date indicated on the form. A member can revoke the authorization at any time.
Download Appointment of Representative English form

Mailing Address & Fax:

Part C (and Part B Drugs) Appeals, and Part C and D Grievances:

Wellcare por Allwell
Appeals & Grievances
Medicare Operations
7700 Forsyth Boulevard
St. Louis, MO 63105

Fax: 1-844-273-2671

Part D Appeals:

Wellcare por Allwell
Medicare Part D Appeals
P.O. Box 31383
Tampa, FL 33631-3383

Fax: 1-866-388-1766

Download Appointment of Representative Spanish form

 

How to Obtain an Aggregate Number of Grievances, Appeals and Exceptions Filed with Wellcare por Allwell

If you have questions please, contact Member Services.