Contacting Community Health Options Member Services Sample Clauses

Contacting Community Health Options Member Services. Community Health Options’ Member Services Associates are available to assist Members in the resolution of complaints. If you have a complaint, we recommend that you contact a Member Services Associate before filing an Appeal. Sometimes, an issue is caused by a minor error or problem that can be resolved by a Member Services Associate without having to go through the Appeal process. You may file an Appeal at any time. You may make a complaint by calling Member Services. You can also make a written complaint by mailing or faxing it to: Community Health Options Attn: Member Services Mail Stop 100 P.O. Box 1121 Lewiston, ME 04243 Fax: 207‐402‐3745 After we receive your complaint, a Member Services Associate will look into it and respond. Please contact Member Services if you have questions. Community Health Options will respond to you as quickly as we can. Most complaints can be investigated and responded to within 30 days. If you disagree with our response, you may be able to file an Appeal. If you are not satisfied with the results of your Complaint or Appeal, you have the right to submit a complaint to the Maine Bureau of Insurance: Maine Bureau of Insurance 00 Xxxxx Xxxxx Xxxxxxx Xxxxxxx, XX 00000 Telephone: 1‐800‐300‐5000 (within Maine) or 1‐207‐624‐8475 (outside Maine)
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Related to Contacting Community Health Options Member Services

  • Government and Service Employees' Union The leave shall be for a period of three years and shall be renewed upon request.

  • Clinical Management for Behavioral Health Services (CMBHS) System The CMBHS is the official record of documentation by System Agency. Grantee shall:

  • Enterprise Information Management Standards Grantee shall conform to HHS standards for data management as described by the policies of the HHS Office of Data, Analytics, and Performance. These include, but are not limited to, standards for documentation and communication of data models, metadata, and other data definition methods that are required by HHS for ongoing data governance, strategic portfolio analysis, interoperability planning, and valuation of HHS System data assets.

  • Citizen Volunteer or Community Service Leave Leave without pay may be granted for community volunteerism or service.

  • Community Services a) Grantee shall provide the community-based services outlined in Texas Health and Safety Code Texas Health and Safety Code Chapter § 534.053, as incorporated into services defined in Information Item G, incorporated by reference and posted at: xxxxx://xxx.xxx.xxxxx.xxx/doing-business-hhs/provider-portals/behavioral-health- services-providers/behavioral-health-provider-resources/community-mental-health- contracts.

  • Covered Health Care Services We agree to provide coverage for medically necessary covered health care services listed in this agreement. If a service or category of service is not specifically listed as covered, it is not covered under this agreement. Only services that we have reviewed and determined are eligible for coverage under this agreement are covered. All other services are not covered. See Section 1.4 for how we identify new services and our guidelines for reviewing and making coverage determinations. We only cover a service listed in this agreement if it is medically necessary. We review medical necessity in accordance with our medical policies and related guidelines. The term medically necessary is defined in Section 8.0 - Glossary. It does not include all medically appropriate services. The amount of coverage we provide for each health care service differs according to whether or not the service is received:  as an inpatient;  as an outpatient ;  in your home;  in a doctor’s office; or  from a pharmacy. Also coverage differs depending on whether:  the health care provider is a network provider or non-network provider;  deductibles (if any), copayments, or maximum benefit apply;  you have reached your plan year maximum out-of-pocket expense;  there are any exclusions from coverage that apply; or  our allowance for a covered health care service is less than the amount of your copayment and deductible (if any). In this case, you will be responsible to pay up to our allowance when services are rendered by a network provider. Please see the Summary of Medical Benefits to determine the benefit limits and amount that you pay for the covered health care services listed below. Please see the Summary of Pharmacy Benefits to determine the benefit limits and amount that you pay for prescription drug and diabetic equipment and supplies purchased at a pharmacy.

  • Recognition of Union Stewards and Grievance Committee In order to provide an orderly and speedy procedure for the settling of grievances, the Employer acknowledges the rights and duties of the Union Stewards. The Xxxxxxx shall assist any Employee, which the Xxxxxxx represents, in preparing and presenting her grievance in accordance with the grievance procedure.

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