Grievances And Appeals For BlueCard And Guest Membership Services Clause Samples

Grievances And Appeals For BlueCard And Guest Membership Services. If the Member has a problem or concern about the services or Benefits received through the BlueCard or Guest Membership Programs the Member has the same right to file a Grievance or to appeal a coverage decision as when in Keystone’s Limited Network Area and receiving care from the HMO Providers. The HMO will retain responsibility for Benefits provided through the BlueCard and Guest Membership Programs. Refer to the Grievance and Appeals section for a complete explanation of the process and procedure for filing a Grievance or an appeal. When filing a Grievance or appeal involving BlueCard or Guest Membership Services, the Member should identify that the BlueCard or Guest Membership Program was being used and indicate which of its specific services (Urgent Care, Follow-Up Care, or the Guest Membership) are at issue.