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Managing

integrated healthcare

with a conscience.

What is an appeal and how do I file an appeal?

 

What is an appeal?

An appeal is a formal request to review an action or decision related to your behavioral health services.

 

There are 3 types of appeals depending on what is being appealed and who is filing the appeal.  The 3 types of appeals are:

  • Appeals for Title XIX/XXI AHCCCS eligible persons,
  • Appeals for persons determined to have a Serious Mental Illness, and
  • Appeals for persons who are not enrolled as a person with Serious Mental Illness and are Non-Title XIX/XXI eligible.

 

 

How do I file an appeal?

Appeals can be filed orally or in writing with NARBHA within 60 days of receiving a Notice of Action.  A Notice of Action is a written letter that tells you about a change in your services.  An expedited appeal will be resolved sooner than a standard appeal due to the urgent behavioral health needs of the person filing the appeal.  Contact NARBHA Member Services or your provider to see if your appeal will be expedited.

 

You can file an appeal or your legal or authorized representative, including a provider, can file an appeal for you with your written permission.  You can also get help with filing an appeal by yourself.

 

To file an appeal orally or for help with filing a written appeal, call NARBHA Grievance and Appeals or NARBHA Member Services at (928) 774-7128 or toll-free at 1-800-640-2123; for hearing impaired, please use the Arizona Relay Service at 711 or 1-800-367-8939 or internet assistance at http://www.azrelay.org/.

 

To file a written appeal, mail the appeal to NARBHA Office of Grievance and Appeals, 1300 South Yale Street, Flagstaff, AZ 86001.

 

You will get written notice that your appeal was received within 5 working days.  If your appeal needs to be expedited, you will get notice that your appeal was received within 1 working day.