FEHB appeals form

What happens next

Our review process

  1. A group of Priority Health employees who are experienced in coverage issues informally reviews your request.
  2. If they can't resolve it to your satisfaction, they send your appeal to the Priority Health Grievance Committee.
  3. The Grievance Committee includes Priority Health employees and a medical doctor, none of whom were involved in the initial decision we made or work directly for someone who made that initial decision. They make a decision about your appeal. The decision may be all or partly in your favor, or all against you.
  4. The Committee sends you a letter summarizing its findings and decision within 5 days after the committee meeting. We also call you.

If you're not satisfied with the resolution of the appeal, you may ask the Office of Personnel Management (OPM) to review it. See the FEHB Appeals Process document for for information.