You, your prescriber, treating provider, or authorized representative may request an initial decision or appeal using the contact information in the table below. You or your authorized representative may also submit a grievance using the contact information below. For more information on how to authorize someone to represent you during an appeal, select the link: Appointment of Representative (Form CMS-1696 (11/15)).
For a complete description of these processes, refer to the section titled, "What to do if you have a problem or complaint (coverage decisions, appeals, complaints)," in your Evidence of Coverage. For more information about Prescription Drug (Medicare Part D) limitations and exceptions, including prescriptions needing prior authorization, those with quantity limits and those with step therapy criteria, please refer to the Senior Preferred Part D Formulary.
Check on the status of a request or grievance
You may also check on the status of a request or grievance by calling one of the numbers listed below.
How to request a report
You can request a report on the total number of grievances, appeals, and exceptions filed with Senior Preferred by calling Customer Service or sending a written request to our Customer Service Department at the address listed below.