- If a beneficiary would like to appoint a person to file a grievance, request a coverage determination or exception, or request an appeal on his or her behalf, for a single event, the beneficiary and the person accepting the appointment must fill out this form (or a written equivalent) and submit it with the request.
PrimeTime Health Plan is committed to providing our members timely resolutions for all questions, complaints, or concerns. If you ever have questions or issues with PrimeTime Health Plan, your benefits, or our providers, please let us know so we can help. Our representatives are available by phone to assist you Monday through Friday, 8:00 am-8:00 pm at 330-363-7407 or toll-free at 1-800-577-5084 (TTY: 711). From October 1st - March 31st, our representatives are available 7 days a week, 8 a.m. to 8 p.m. If you would like to meet with a customer service representative in person, you can visit us during our office hours, Monday through Friday. Our office hours are 8:00 a.m. to 4:30 p.m.
You can also submit a complaint directly to Medicare if you’d like by completing the Medicare Complaint Form. The office of the Medicare Ombudsman (OMO)helps you with complaints, grievance and information requests. Visit their website here.
SPECIAL COMMUNICATION NEEDS
If you or someone you know requires the assistance of a translator, please contact our Service Center at 330-363-7407 or toll-free at 1-800-577-5084 and we will gladly provide one for you. To access our TTY phone line, please dial 711 for the hearing impaired.
PRIMETIME HEALTH PLAN PrimeTime Health Plan is an HMO-POS plan with a Medicare contract. Enrollment in PrimeTime Health Plan depends on contract renewal. Every year, Medicare evaluates plans based on a 5-star rating system.
PrimeTime Health Plan complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. PrimeTime Health Plan does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. PrimeTime Health Plan provides free aids and services to people with disabilities to communicate effectively with us, such as Qualified sign language interpreters and written information in other formats (large print, audio, accessible electronic formats, other formats). PrimeTime Health Plan provides free language services to people whose primary language is not English, such as Qualified interpreters and information written in other languages. If you need these services, or if you believe that PrimeTime Health Plan has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can contact or file a grievance with the: PrimeTime Health Plan Civil Rights Coordinator, 2600 6th St. S.W. Canton, OH 44710, 330-363-7456, CivilRightsCoordinator@aultcare.com. You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, our Civil Rights staff is available to help you. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 200 Independence Avenue, SW Room 509F, HHH Building Washington, D.C. 20201 1-800-368-1019, 800-537-7697 (TDD). Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html