Part C Organization Determinations, Appeals and Grievances

Get more information

For more information on appointing a representative requesting an authorization or submitting a request for reimbursement:

Aspirus Health Plan Medicare Advantage

Instructions for Appointing a Representative (PDF)
Medicare Authorizations (PDF)
Medicare Claim Reimbursement Form (PDF)
Appointment of Representative Form (CMS Form-1696)

Appeals and Grievances

What is a grievance? (PDF)
Appeals form (PDF)
Complaint form (PDF)

Mailing address

Attn: Appeals and Grievances
Aspirus Health Plan
P.O. Box51
Minneapolis, MN 55440-9972

Email

cagMA@aspirushealthplan.com

Fax

You can also fax your written complaint to us at 715-787-7439 or 1-855-931-4858 toll free.

Phone

715-631-7440 or 1-855-931-4858 toll free
TTY users call: 715-631-7413 or 1-855-931-4852 toll free

Customer service

715-631-7411 or 1-855-931-4850 toll free
TTY users call: 715-631-7413 or 1-855-931-4852 toll free.

H6874_11281_092021
U11835 05/2022