Common use of Grievance Processes for Complaints and Appeals Clause in Contracts

Grievance Processes for Complaints and Appeals. The grievance processes to express a complaint and appeal a denial of benefits are set forth below. Filing a Complaint or Appeal The complaint process is available for a Member to express dissatisfaction about customer service or the quality or availability of a health service. The appeals process is available for a Member to seek reconsideration of a denial of benefits. Complaint Process Step 1: The Member should contact the person involved, explain his/her concerns and what he/she would like to have done to resolve the problem. The Member should be specific and make his/her position clear.

Grievance Processes for Complaints and Appeals. The grievance processes to express a complaint and appeal a GHC denial of benefits are set forth below. Filing a Complaint or Appeal The complaint process is available for a Member to express dissatisfaction about customer service or the quality or availability of a health service. The appeals process is available for a Member to seek reconsideration of a denial of benefits. Complaint Process Step 1: The Member should contact the person involved, explain his/her concerns and what he/she would like to have done to resolve the problem. The Member should be specific and make his/her position clear.