Grievance Determination Sample Clauses

Grievance Determination. Qualified personnel will review Your Grievance, or if it is a clinical matter, a licensed, certified or registered health care professional will look into it. We will decide the Grievance and notify You within the following timeframes: Expedited/Urgent Grievances : By phone, within the earlier of 48 hours of receipt of all necessary information or 72 hours of receipt of Your Grievance. Written notice will be provided within 72 hours of receipt of Your Grievance.
AutoNDA by SimpleDocs
Grievance Determination. Qualified personnel will review Your Grievance, or if it is a clinical matter, a licensed, certified or registered health care professional will look into it. We will decide the Grievance and notify You within the following timeframes: Expedited/Urgent Grievances: By phone, within the earlier of 48 hours of receipt of all necessary information or 72 hours of receipt of Your Grievance. Written notice will be provided within 72 hours of receipt of Your Grievance. Pre-Service Grievances: (A request for a service or treatment that has not yet been provided.) In writing, within 15 calendar days of receipt of Your Grievance.
Grievance Determination. Qualified personnel will review your grievance, or if it is a clinical matter, a licensed, certified, or registered healthcare professional will look into it. We will decide the grievance and notify you within the following timeframes: Expedited/Urgent Grievances: By phone, within 48 hours of receipt of all necessary information In writing, within 3 business days after we notify you by phone Referrals/Covered Benefit Determination: In writing, within 30 calendar days of receipt of all necessary information All Other Grievances: In writing, within 45 calendar days of (that are not in relation to a receipt of all necessary information claim or request for a service)
Grievance Determination. 32 The Grievance Committee, upon receiving a written and signed petition, shall 33 determine if, in their opinion, a grievance exists. If in their opinion no grievance 34 exists, no further actions shall be taken. Once the committee determines that a 35 grievance exists the Association shall become the “grievant” as the term is used 36 in this article. 37 38 Step 2 39 If the Grievance Committee believes a grievance does exist, the Grievance 40 Committee shall, within twenty (20) days from the event giving rise to a 41 grievance, or from the date the committee could reasonably have been expected 42 to have had knowledge of such event, shall submit a written grievance form to

Related to Grievance Determination

  • Grievance Mediation a) At any stage in the grievance procedure, the parties by mutual consent in writing may elect to resolve the grievance by using grievance mediation. The parties shall agree on the individual to be the mediator and the time frame in which a resolution is to be reached.

  • Grievance and Appeals Unit See Section 9 for contact information. You may also contact the Office of the Health Insurance Commissioner’s Consumer Resource Program, RIREACH at 1-855-747-3224 about questions or concerns you may have. Complaints A complaint is an expression of dissatisfaction with any aspect of our operation or the quality of care you received from a healthcare provider. A complaint is not an appeal. For information about submitting an appeal, please see the Reconsiderations and Appeals section below. We encourage you to discuss any concerns or issues you may have about any aspect of your medical treatment with the healthcare provider that furnished the care. In most cases, issues can be more easily resolved if they are raised when they occur. However, if you remain dissatisfied or prefer not to take up the issue with your provider, you can call our Customer Service Department for further assistance. You may also call our Customer Service Department if you are dissatisfied with any aspect of our operation. If the concern or issue is not resolved to your satisfaction, you may file a verbal or written complaint with our Grievance and Appeals Unit. We will acknowledge receipt of your complaint or administrative appeal within ten (10) business days. The Grievance and Appeals Unit will conduct a thorough review of your complaint and respond within thirty (30) calendar days of the date it was received. The determination letter will provide you with the rationale for our response as well as information on any possible next steps available to you. When filing a complaint, please provide the following information: • your name, address, member ID number; • the date of the incident or service; • summary of the issue; • any previous contact with BCBSRI concerning the issue; • a brief description of the relief or solution you are seeking; and • additional information such as referral forms, claims, or any other documentation that you would like us to review. Please send all information to the address listed on the Contact Information section.

  • Grievance A grievance is an alleged violation, misinterpretation, or misapplication of the terms of the negotiated agreement between the Board and the Association.

  • Grievance Arbitration Notwithstanding any other provision of this Agreement, for the purposes of this Article, an Employee has the right to grieve any filling of a vacancy or Assignment in the bargaining unit.

  • Grievance Defined A grievance is defined as an alleged breach of the terms and conditions of this Agreement. It is the desire of the parties to this Agreement that grievances be adjusted informally wherever possible and at the first level of supervision.

  • Grievance Redressal Level 1 We are committed to resolving your queries/issues within 7 working days. If you do not hear from us within this time, or you are not satisfied with our resolution of your query, the customer may write to us at xxxxxxxxxxxxxxxxxxxxxx@xxxxxxxxxxxx.xx Level 2 If the customer is not satisfied with the resolution provided at level 1 within 2 working days, the customer may post his/her complaint to the head of Customer Experience at xxxxxxxxxxxxxxxxxxxxxx@xxxxxxxxxxxx.xx Alternatively, the customers may write to The Head of Customer Experience at: Bajaj Housing Finance Limited, 5th Floor, B2 Cerebrum IT Park, Kumar City Kalyani Nagar Pune, Maharashtra Pin – 411014 Level 3 If the customer is not satisfied with the resolution provided at level 1 within 2 working days, the customer may post his/her complaint to the head of Customer Experience at xxxx.xxxxxx@xxxxxxxxxxxx.xx Alternatively, the customers may write to National Manager – Service: Xxxx Xxxxxx Bajaj Housing Finance Limited, 5th Floor, B2 Cerebrum IT Park, Kumar City Kalyani Nagar Pune, Maharashtra Pin – 411014 Level 4 In case of non-redressal of the complaint to the customer’s satisfaction, within 7 working days from the above-mentioned matrix, the customer may approach the National Housing Bank by lodging its complaint in online mode at the link xxxxx://xxxxx.xxxxxxxxx.xxx.xx or in offline mode by post at the address given below in the prescribed format available at link (xxxx://xxx.xxx.xx/citizencharter/NHB%20Grievance%20Redressal%20Policy.pdf) National Housing Bank, Department of Regulation and Supervision, (Complaint Redressal Cell), 4th Floor, Core-5A, India Habitat Centre, Lodhi Road, New Delhi- 110003 Grievance Process The below-mentioned process is followed when a Xxxxxxxx writes to xxxxxxxxxxxxxxxxxxxxxx@xxxxxxxxxxxx.xx : • Customer service associate reads the entire email to understand the customer query • Xxxxxxxx is contacted to understand his/its requirements • Grievance Team coordinates with internal departments to get the complaint resolved as per the defined timeline. • If the resolution is not possible within the defined TAT of 7 working days, due to internal and external dependencies, interim response along with timelines is sent to the Borrower. • All queries are closed on e-mail and via telephone call. Timely update is sent to the Borrower in case of any extension required in committed timelines.

  • Formal Grievance Step 1 6

Draft better contracts in just 5 minutes Get the weekly Law Insider newsletter packed with expert videos, webinars, ebooks, and more!