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Filing a Grievance

Grievances are spoken or written complaints submitted to Louisiana Healthcare Connections by you or your Authorized Representative. These complaints may concern any action of Louisiana Healthcare Connections, including, but not limited to:

  • prior authorization requirements
  • quality of care
  • administrative processes or operations

Louisiana Healthcare Connections wants to resolve any concerns you may have. We will not hold it against you or treat you differently if you file a Grievance.

How to File a Grievance

You can file a Grievance by calling us at 1-866-595-8133 (TTY: 711). You can also file your Grievance by mail or by fax to:

Louisiana Healthcare Connections 
ATTN: Grievances
P.O. Box 84180
Baton Rouge, LA 70884

Fax: 1-877-401-8170

Be sure to include:

  • Your first and last name
  • Your Medicaid ID number
  • Your address and telephone number
  • What you are unhappy with
  • What you would like to have happen

You can file a Grievance at any time. If you file a written Grievance, we will send you a letter within five (5) business days letting you know we have received it.

Louisiana Healthcare Connections maintains records of each Grievance, as well as all responses, for six (6) years.

If someone else is going to file a Grievance for you, we must have your written permission for that person to file your Grievance. The “Appeal Representative" form can be used to give the right to file your Grievance or Appeal to someone else. You can call Member Services to receive a form or go to the Member Handbooks and Forms page. 

If you have any proof or information supporting your Grievance, you may send it to us and we will add it to your case. You may send this information to Louisiana Healthcare Connections by fax or by letter. You may also request to receive copies of any documentation Louisiana Healthcare Connections used to make the decision about your care or Grievance.

You can expect a resolution and a written response within 90 days of your Grievance. Most Grievances are resolved within 30 days. If we need more than 90 days, we will contact you.

We will not hold it against you or treat you differently in any way if you file a Grievance. We want to know your concerns so we can improve our services.

How to File a Pharmacy-Related Grievance

Grievances related to your pharmacy benefits must be sent to Prime Therapeutics State Government Solutions (Prime Therapeutics), Louisiana Medicaid’s Pharmacy Benefits Manager. You can get this form on the Member Handbooks and Forms page.

You can file a Grievance with Prime Therapeutics by:

  • Calling Prime Therapeutics' 24/7 Member Help Desk at 1-800-424-1664 (TTY: 711)
  • Mailing your Grievance to:
    Prime Therapeutics
    Attn: GV — 4201
    P.O. Box 64811
    St. Paul, MN 55164-0811
  • Faxing your Grievance to 1-800-424-7402