Grievance and Appeal System. 1. General Requirements (42 CFR §438.402).
i. The Contractor shall have a grievance and appeal system in place for beneficiaries.
ii. The Contractor shall have only one level of appeal for beneficiaries.
iii. Filing requirements:
Grievance and Appeal System. The processes the Contractor implements to handle Appeals of an Adverse Benefit Determination and Grievances, as well as the processes to collect and track information about them.
Grievance and Appeal System. The processes the Health Plan implements to handle appeals of an adverse benefit determination and grievances, as well as the processes to collect and track information about them. Habilitation Services and Devices: Health care service and devices that help a person keep, learn, or improve skills and functioning for daily living.
Grievance and Appeal System. CONTRACTOR shall utilize COUNTY’S designated grievance and appeal system for resolving disputes and grievances.
Grievance and Appeal System. The processes implemented to handle Appeals of Adverse Benefit Determinations and Grievances, as well as the processes to collect and track information about them. 42 CFR 438.400. HMP refers to Healthy Michigan Plan, Michigan’s Medicaid expansion program which became effective on April 1, 2014, to serve newly enrolled persons. HMP expanded the array of services available for persons with substance use disorders in need of treatment. LOS means Length of Stay. MDHHS refers to the Michigan Department of Health and Human Services (MDHHS).
Grievance and Appeal System. Available Resources Exhausted
Grievance and Appeal System. The processes the PIHP implements to handle appeals of an adverse benefit determination and grievances, as well as the processes to collect and track information about them. Habilitation Services and Devices: Health care service and devices that help a person keep, learn, or improve skills and functioning for daily living.
Grievance and Appeal System. The overall system that includes Complaints, Grievances, and Appeals at the Contractor level, as well as access to the Administrative Law Hearing process. Health Care Acquired Conditions: A medical condition for which an individual was diagnosed that could be identified by a secondary diagnostic code described in Section 1886(d)(4)(D)(iv) of the Social Security Act.
Grievance and Appeal System. The term “
Grievance and Appeal System. The Subcontractor shall assist members in understanding their right to file grievances and appeals in conformance with all AHCCCS Grievance and Appeal System and member rights policies.
