Grievance & Appeals
Cenpatico's Grievance & Appeals Department exists to assist members and providers in processing Title XIX/XXI appeals, SMI appeals, SMI Grievances, and provider claim disputes.
Cenpatico providers are required to respond to a member's concerns and complaints regarding treatment.
Each member maintains the right to appeal Title XIX/XXI actions, and SMI treatment decisions. In addition, SMI members maintain the right to file grievances.
Providers must report potential rights violations to the Grievance & Appeals Department. Additionally, providers are required to assist members in filing grievances and/or appeals. If you have a member who requests to file a grievance or appeal, please complete PM Form 5.3.1 ADHS/DBHS Appeal or SMI Grievance and fax the completed copy of the form to 1-866-714-7998, attention Grievance & Appeals.
The AHCCCS Office of Human Rights is also available for advocacy assistance for members with SMI at 1-800-421-2124.