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Complaints Policies and Processes

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.

We hope we serve you well. If you are unhappy or have a complaint with any of your state-funded behavioral health, intellectual and developmental disability (I/DD) or traumatic brain injury (TBI) state-funded services, case manager, Alliance Health or service provider, you may call Member and Recipient Services at 800-510-9132 or write to:

Alliance Health
Quality Management Department
Attn: Complaints and Grievances
5200 W. Paramount Parkway, Suite 200
Morrisville, NC 27560

EMAIL: [email protected]

Contacting us with a complaint means that you are unhappy with Alliance Health, your provider, or your services. Most problems like this can be solved right away. Whether we solve your problem right away or need to do some work, we will record your call, your concern, and our solution. We will inform you that we have received your complaint in writing. We will also send you a written notice when we have finished working on your complaint.

You can ask a family member, a friend, your provider, or a legal representative to help you with your complaint. If you need our help because of a hearing or vision impairment, or if you need translation services, or help filling out any forms, we can help you.

You can contact us by phone, electronically or in writing:

PHONE: Call Member and Recipient Services at 800-510-9132 Monday through Saturday, 7 a.m.–6 p.m. After these hours, you may leave a message.

MAIL: You can write us with your complaint to:
Alliance Health
Quality Management Department
Attn: Complaints and Grievances
5200 W. Paramount Parkway, Suite 200
Morrisville, NC 27560

EMAIL: [email protected]

Resolving Your Complaint

We will let you know in writing that we got your complaint within five business days of receiving it. Our letter will also let you know whether we will address the complaint informally or by conducting an investigation. If you do not agree with the resolution of the complaint, you may file an appeal.

  • If we address the complaint informally, we will review your complaint and tell you how we resolved it in writing within 15 business days from receiving your complaint.
  • If we do an investigation of your complaint, we will complete the investigation with 30 days from receiving your complaint and tell you how we resolved it in writing within 15 days of completing the investigation.
  • If you do not agree with the resolution/outcome of the complaint, you may file an appeal with Alliance Health within 15 business days from the date of the informal resolution letter or within 21 calendar days from the receipt of the investigation report. You can ask a family member, a friend, your provider, or a legal representative to help you with your appeal. The appeal for an investigation is limited to items identified in the original complaint record and the investigation report. Alliance Health will convene a review committee to review the appeal and the Health Plan will issue a written decision based on the appeal committee’s decision to uphold or overturn the findings of the investigation. The decision letter will be dated within 28 calendar days from receipt of the appeal for an investigation and within 20 business days from receipt of the appeal of an informal decision.
  • You may also contact the Customer Service and Community Rights (CSCR) team of the Division of Mental Health, Developmental Disabilities and Substance Abuse Services (DMH/DD/SAS) by phone at 984-236-5200 or email at [email protected]. The CSCR team will work with you and the Health Plan for any possible options for services.
This page was last reviewed for accuracy on 02/06/2022