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Filing Appeals and Grievances with TPAs

Evergreen Health has delegated the appeals and grievance process to the following third-party administrators (TPAs). To file an appeal or grievance with a TPA, please consult the following chart.

CATEGORY VENDOR CLINICAL GRIEVANCES CLAIMS APPEALS
Behavioral Health ValueOptions National Peer Advisor
12369-C Sunrise Valley Drive
Reston, VA 20190
P.O. Box 1850
Hicksville, NY 11802
Vision Superior Vision, formerly known as Block Vision 939 Elkridge Landing Road, Suite 200
Linthicum, MD 21090
cag@superiorvision.com
939 Elkridge Landing Road, Suite 200
Linthicum, MD 21090
cag@superiorvision.com
Pediatric Dental Liberty Dental Attn: Quality Management
Department
P.O. Box 26110
Santa Ana, CA 92799-6110
Attn: Quality Management
Department
P.O. Box 26110
Santa Ana, CA 92799-6110
Retail Pharmacy OptumRx P.O. Box 5252
Lisle, IL 60532
Fax: (866) 511-2202
P.O. Box 5252
Lisle, IL 60532
Fax: (866) 511-2202