Filing a Grievance

Grievance Process

Sunflower Health Plan wants to help you with any problems or concerns you have. If you’re unhappy with something, you can file a grievance to tell us you’re not satisfied.

These are examples of reasons you might file a grievance:

• There was a problem with your care or services.
• A provider or employee was rude.
• You feel your rights were violated.

Key Points:

• Filing a grievance won’t affect your care or how we treat you.
• You cannot file grievances about Value-Added Benefits.
• You can file a grievance by phone or in writing. There is no deadline.
• To help us review your grievance, please give us:
  • Your first and last name.
  • Your Medicaid ID.
  • Your phone number.
  • Details of the issue.
  • What you want us to do to fix the problem.
• Someone else can file a grievance for you if you sign a permission form. Get this form from Customer Service or the Sunflower website. Fill it out and return it by mail or fax..
• Send any supporting documents to Sunflower by mail or fax.
• You can ask to see the documents we used to decide on your grievance.
• Sunflower can help with filling out any forms needed.
• The KanCare Ombudsman can help with:
  • Your rights and responsibilities.
  • Problems with Sunflower.
  • Issues with getting the care you need.
  • Rights violations.
  • Visit the KanCare Ombudsman website for more information.. Learn more on our KanCare Ombudsman page.
• Urgent grievances will be resolved in 72 hours. Non-urgent grievances will be handled in 30 calendar days.

Sunflower wants to fix your concerns quickly. If we cannot solve your concern in 30 calendar days, we can ask for up to 14 extra calendar days to gather more information. If we need extra time, we will call by phone and send you a letter explaining why. You can also ask for more time. To ask for more time, let us know at least two business days before the 30-day deadline.