General Policies and Procedures for Grievances and Appeals. The Contractor shall have written policies and procedures that describe the grievance and appeals process and how it operates; and the process. These written directives shall describe how the Contractor intends to receive, track, review, and report all enrollee inquiries, grievances and appeals. The Contractor shall make any changes to its enrollee grievance and appeal procedures that are required by the Division. The procedures and any changes to the procedures must be submitted to the Division annually. The Contractor shall provide grievance and appeal forms and/or written procedures to enrollees who wish to register written grievances or appeals. Additionally, the Contractor shall provide reasonable assistance in completing forms and taking other procedural steps including, but not limited to, providing interpreter services and toll-free numbers that have adequate TTY/TTD and interpreter capability. The procedures must provide for prompt resolution of the issue and involve the participation of individuals with the authority to require corrective action. Specific requirements regarding enrollee notices, grievances, and appeals are contained in this Article. The grievance and appeals processes must be integrated with the Contractor’s process. The grievance and appeals process shall include the following:
Appears in 5 contracts
Samples: medicaid.ms.gov, medicaid.ms.gov, www.medicaid.ms.gov
