Filing a Grievance
Grievances are spoken or written expressions of dissatisfaction given to Western Sky Community Care by you or your authorized representative. These complaints can be about any action of Western Sky Community Care or a provider in our network. Grievances include, but are not limited to:
- Quality of care
- Personal behavior like rudeness of a provider or employee
- Failure to respect a member's rights
- Harmful administrative processes or operations
Western Sky Community Care wants to resolve your concerns. We will not hold it against you if you file a grievance. We will not treat you differently.
How to File a Grievance
You can file an grievance in any way that works best for you. You can:
- Call Member Services. The phone number is 1-844-543-8996 (TTY: 711).
- Send it electronically by fax. The fax number is 1-844-235-6050.
- By email. Use the Secure Member Portal to file using email.
- Write a letter and mail it to us.
- We have a form available to help you file a grievance. The Grievance/Appeal Form is available on our Forms page.
Send your grievance to:
Western Sky Community Care
5300 Homestead Road NE
Albuquerque, NM 87110
If you would like an authorized representative to file on your behalf, please complete an authorization form. The Authorized Representative Designation Form is available on our Forms page. It should be mailed or faxed with your request.
There is no time limit on when you or your authorized representative can file a grievance.
Within five business days of receiving your grievance, we will send you a letter so you know we received it. We strive to resolve all issues as quickly as possible. We will notify you no later than 30 days from the date of your grievance with our decision. The notification of our decision will include any further appeal rights you may have.
You can find detailed information about grievances in our Member Handbook.