Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with Golden Rule Insurance Company before sending sensitive documents. FaxFlow is not affiliated with this organization.
Golden Rule Insurance Company fax number
(801) 478-7595
Grievance Administrator
Used for: Health care appeals/grievances for adverse determinations on health care services (appeal process for denials, reductions, or coverage issues).
Fax destination details
- Department
- Grievance Administrator
- Purpose
- Health care appeals/grievances for adverse determinations on health care services (appeal process for denials, reductions, or coverage issues).
- Form
- 33570-G — HEALTH CARE APPEAL REQUEST FORM
- Address
- Grievance Administrator, Golden Rule Insurance Company, PO Box 31379, Salt Lake City, UT 84131
- Voice phone
- 1-800-657-8205
- Website
- Visit organization website
Before you send
- Confirm that this exact department handles your document or request.
- Check the organization website or call its main line for the current fax number.
- Include a cover sheet and any case, member, claim, or form reference required.
- Keep the delivery confirmation with your submission records.
Use this form to tell your insurer you want to appeal a denial decision; include the decision being appealed, supporting documentation, and any expedited-certification from the treating provider if requesting expedited review.
Official form instructions are published as a downloadable file on the organization's website.
Sources and verification
FaxFlow records the public sources found during directory research. A source link is useful evidence, but it is not a guarantee that a number still reaches the same team.
No public source link was saved with this record. Confirm the number directly with the organization before using it.