Grievances and Appeals. Participants and Preferred Providers may submit grievances and appeal qualified ACO decisions in accordance with the ACO Appeals Policy, available on the ACO Provider Portal and incorporated herein by reference.
Appears in 4 contracts
Samples: Risk Bearing Participant & Preferred Provider Agreement, Onecare Provider Agreement, Risk Bearing Participant & Preferred Provider Agreement
Grievances and Appeals. Participants and Preferred Providers Affiliates may submit grievances and appeal qualified ACO decisions in accordance with the ACO Appeals Policy, available on the ACO Provider Portal and incorporated herein by reference. To the extent an ACO Program dictates a specific appeals process that conflicts with the ACO Appeals Policy, the more restrictive policy shall apply.
Appears in 2 contracts
Samples: Risk Bearing Participant & Affiliate Agreement, Risk Bearing Participant & Affiliate Agreement
