Common use of Information on Grievance, Internal Appeal, and Board of Hearing Clause in Contracts

Information on Grievance, Internal Appeal, and Board of Hearing. (BOH) procedures and timeframes, including: a) The right to file Grievances and Internal Appeals; b) The requirements and timeframes for filing a Grievance or Internal Appeal; c) The availability of assistance in the filing process; d) The toll-free numbers that the Enrollee can use to file a Grievance or an Internal Appeal by phone; e) The fact that, when requested by the Enrollee, ACO Covered Services will continue to be provided if the Enrollee files an Internal Appeal or a request for a BOH hearing within the timeframes specified for filing, and that the Enrollee may be required by EOHHS to pay the cost of services furnished while a BOH Appeal is pending, if the final decision is adverse to the Enrollee; f) The right to obtain a BOH hearing; g) The method for obtaining a BOH hearing; h) The rules that govern representation at the BOH hearing; and i) The right to file a grievance directly with EOHHS, how to do so, and EOHHS contact information;