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Complaints

  • A Complaint is any issue you may have with Partners Health Plan, our vendors, or our provider network.
  • You may file a Complaint with Partners Health Plan at any time, verbally or in writing.
  • Partners Health Plan will resolve Fast Track Complaints within 48 hours of receipt of all necessary information, but no longer than 7 days from receipt of the Complaint.
  • Partners Health Plan will resolve Standard Complaints within 45 days of receipt of all necessary information, but no longer than 60 days from receipt of the Complaint.
  • You will receive a Complaint Resolution Notice in the mail notifying you of our decision.

Complaint Appeals

  • If you are dissatisfied with the decision of your complaint, you may file a Complaint Appeal within 60 business days from receipt of the Complaint Resolution Notice.
  • Partners Health Plan will resolve Expedited Complaint Appeals within 2 business days of receipt of all necessary information.
  • Partners Health Plan will resolve Standard Complaint Appeals within 30 business days of receipt of all necessary information.
  • You will receive a Complaint Appeal Resolution Notice in the mail notifying you of our decision.
  • If you would like to file a Complaint Appeal online, please email appeals@phpcares.org.

Department of Health Complaints

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