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Appeal Process

As a Unity member, you have the right to voice a complaint or file a grievance regarding any dissatisfaction you experience with your health plan. Unity will provide you with a prompt and fair review of your concern and respond to you within 30 days.

To file a complaint
If you have a concern, please contact Unity Customer Service at 800-362-3310.

Unity's Customer Service Representatives are dedicated to resolving your concerns in a timely fashion. If Customer Service cannot resolve the matter, Unity’s Member Advocate will assist you with the appeal process.

Formal grievance process
A step-by-step description of the grievance process is included in your Certificate of Coverage. Following is a summary:

• Unity's Member Advocate will review your concern. If the matter involves a medical issue, qualified medical personnel will also review it.
• If the matter cannot be resolved to your satisfaction, your grievance will be sent to Unity’s Reconsideration Committee.
• In some cases, you may have the right to have an Independent Review Organization (IRO) review your grievance. You must send your request to Unity within 4 months of the date Unity issues its final decision.
• To start the IRO process, you must let us know which IRO you wish to use and enclose a check for $25 payable to that organization. The check will be returned to you if the IRO decides the matter in your favor.

Unity is dedicated to providing quality customer service. Problems can be solved only when they have been identified. 

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