Appeals Policies and Processes
Members have the right to appeal an Alliance decision. Call Alliance at 919-651-8641 if you need help with your appeal request.
Grievance Policies and Processes
We hope our health plan serves you well. If you are unhappy or have a complaint, you may talk with your primary care provider, and you may call Member and Recipient Services at 800-510-9132.
State Fair Hearing Policies and Processes
If you do not agree with Alliance Health’s decision on your appeal, you can ask for a State Fair Hearing. In North Carolina, State Fair Hearings include an offer of a free and voluntary mediation session. This meeting is held before your State Fair Hearing date. For more information about requesting a State Fair Hearing for disenrollment, see your member handbook.
NC Medicaid Ombudsman
The NC Medicaid Ombudsman is a resource you can contact if you need help with your health care needs. The NC Medicaid Ombudsman is an independently operated, nonprofit organization whose only job is to ensure that individuals and families under NC Medicaid Managed Care get access to the care that they need.
You may contact the NC Medicaid Ombudsman at 1-877-201-3750 or visit the Ombudsman website.
