Grievance and Appeal System

Care1st members and providers have access to a grievance and appeal system that fairly and efficiently reviews and resolves identified issues. Grievance system staff address member, provider, and stakeholder concerns in a courteous, responsive, and timely manner. 

The Grievance and Appeal System includes procedures for resolving:

  • Member Grievances
  • Grievances and Investigations Concerning Persons with Serious Mental Illness (SMI)
  • Notice Requirements and Appeal Process (TXIX/XXI)
  • Notice Requirements and Appeal Process (Non-Title XIX/XXI (SMI and GMH/SA)
  • Provider Claim Disputes

Providers must understand the Care1st grievance system in order to assist members who wish to utilize a grievance system process. Grievance system processes also afford Providers a formal process for expressing dissatisfaction, including but not limited to dissatisfaction regarding nonpayment of a claim and service denials.

A Grievance or Appeal may be initiated by calling the Customer Service Department between 8:00 a.m. and 5:00 p.m. at 1-866-560-4042 or TTY/TDY 711.  You may also write to us at:

Care1st Health Plan Arizona
Attention: Grievance and Appeals
1850 W. Rio Salado Parkway Suite 211
Tempe, AZ 85281

Please note: A provider must have written consent to file an appeal on behalf of a member.