To File a Formal Grievance Sample Clauses

To File a Formal Grievance. A Grievance is a written expression of dissatisfaction with Us or with Provider services. If the Member does not feel their Complaint was adequately resolved or they wish to file a formal Grievance, a written request must be submitted within one hundred eighty (180) days of the event that led to the dissatisfaction. For assistance, the Member may call Our Customer Service Department. Send written Grievances to: Blue Cross and Blue Shield of Louisiana Appeals and Grievance Unit P. O. Box 98045 Baton Rouge, LA 70898-9045 A response will be mailed to the Member within thirty (30) business days of receipt of the Member’s written Grievance.
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To File a Formal Grievance. A Grievance is a written expression of dissatisfaction with Us, UCD or with Provider services. If You do not feel Your Complaint was adequately resolved or You wish to file a formal Grievance, You must submit this in writing within one hundred eighty (180) days of the event that lead to the dissatisfaction. UCD Customer Service Department will assist You if necessary. Send Your written Grievance to: United Concordia Dental Customer Service P.O. Box 69420 Harrisburg, PA 17106-9420 A response will be mailed to You within thirty (30) business days of receipt of Your written Grievance.
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To File a Formal Grievance. A Grievance is a written expression of dissatisfaction with Us, the Claims Administrator or with a Provider. If the Member does not feel his Complaint was adequately resolved or he wishes to file a formal Grievance, a written request must be submitted within one hundred eighty (180) days of the event that led to the dissatisfaction. UCD Customer Service Department will assist the Member if necessary. The Member should send his written Grievance to: United Concordia Dental Customer Service P.O. Box 69420 Harrisburg, PA 17106-9420 A response will be mailed to the Member within thirty (30) business days after We receive the Member’s written Grievance. UCD offers two (2) levels of Appeal for both administrative Appeals and Dental Necessity Appeals. If a Member is an ERISA Member, the Member is required to complete the first level of Appeal prior to instituting any civil action under ERISA section 502(a). The second level of Appeal is voluntary. Any statute of limitations or other defense based on timeliness is tolled during the time any voluntary Appeal is pending. The Member’s decision whether or not to submit to this voluntary level of review will have no effect on the Member’s rights to any other Benefits under the plan. No fees or costs will be imposed on the Member. The Member may also call UCD if they have questions or needs assistance putting the Appeal in writing. UCD will determine if a Member’s Appeal is an administrative Appeal or a Dental Necessity Appeal. The Appeals procedure has two (2) levels, including review by a committee at the second level on an administrative Appeal and a review by an external Independent Review Organization (IRO) on a Dental Necessity Appeal. The Member is encouraged to provide UCD with all available information to help completely evaluate the Appeal, such as written comments, documents, records, and other information relating to the Adverse Benefit Determination. UCD will provide the Member, upon request and free of charge, reasonable access to, and copies of, all documents, records, and other information relevant to the Adverse Benefit Determination. The Member has the right to appoint an authorized representative to represent him in his Appeals. An authorized representative is a person to whom the Member has given written consent to represent him in a review of an Adverse Benefit Determination. The authorized representative may be the Member’s treating Provider, if the Member appoints the Provider in writing. All Appe...
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To File a Formal Grievance. A Grievance is a written expression of dissatisfaction with Us or with Provider services. If the Member does not feel his Complaint was adequately resolved or he wishes to file a formal Grievance, a written request must be submitted within one hundred eighty (180) days. Xxxxx Vision customer service department will assist the Member if necessary. The Member should send his written Grievance to: P. O. Box 791 Latham, NY 12110 A response will be mailed to the Member within (thirty) 30 business days of receipt of the Member’s written Grievance.
Sample 1Sample 2Sample 3See All (4)
To File a Formal Grievance. A Grievance is a written expression of dissatisfaction with Us, the Claims Administrator or with a Provider. If the Member does not feel his Complaint was adequately resolved or he wishes to file a formal Grievance, a written request must be submitted within one hundred eighty (180) days of the event that led to the dissatisfaction. UCD Customer Service Department will assist the Member if necessary. The Member should send his written Grievance to: United Concordia Dental Customer Service P.O. Box 69420 Harrisburg, PA 17106-9420 A response will be mailed to the Member within thirty (30) business days after We receive the Member’s written Grievance.
Sample 1Sample 2
To File a Formal Grievance. A Grievance is a written expression of dissatisfaction with the Claims Administrator or with services rendered by a Provider. If a Plan Participant does not feel their Complaint was adequately resolved or the Plan Participant wishes to file a formal Grievance, the Plan Participant must submit this in writing within 180 days of the event that led to the dissatisfaction. The Claims Administrator’s customer service department will assist the Plan Participant if necessary. Send written Grievances to: United Concordia Dental Customer Service P.O. Box 69420 Harrisburg, PA 17106-9420 A response will be mailed to the Plan Participant within thirty (30) business days after the Claims Administrator receives the written Grievance.
Sample 1Sample 2
To File a Formal Grievance. A Grievance is a written expression of dissatisfaction with Us or with Provider services. If the Member does not feel his Complaint was adequately resolved or he wishes to file a formal Grievance, a written request must be submitted within one hundred eighty (180) days. Xxxxx Vision customer service department will assist the Member if necessary. The Member should send his written Grievance to: P. O. Box 791 Latham, NY 12110 A response will be mailed to the Member within (thirty) 30 business days of receipt of the Member’s written Grievance. Multiple requests to Appeal the same Claim, service, issue, or date of service will not be considered, at any level of review. Xxxxx Vision offers two (2) levels of Appeal for both administrative Appeals and Medical Necessity Appeals. If a Member is an ERISA Member, the Member is required to complete the first level of Appeal prior to instituting any civil action under ERISA section 502(a). The second level of Appeal is voluntary. Any statute of limitations or other defense based on timeliness is tolled during the time any voluntary Appeal is pending. The Member’s decision whether or not to submit to this voluntary level of review will have no effect on the Member’s rights to any other Benefits under the plan. No fees or costs will be imposed on the Member. The Member should contact his Employer, Plan Administrator, Plan Sponsor, or Our customer service department at 0-000-000-0000 if the Member is unsure whether ERISA is applicable. The Member may also call Xxxxx Vision if they have questions or need assistance putting their Appeal in writing. Providers will be notified of Appeal results only if the Provider filed the Appeal.
Sample 1
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To File a Formal Grievance. A Grievance is a written expression of dissatisfaction with the Claims Administrator or with services rendered by a Provider. If a Plan Participant does not feel their Complaint was adequately resolved or the Plan Participant wishes to file a formal Grievance, the Plan Participant must submit this in writing within one hundred eighty (180) days of the event that led to the dissatisfaction. The Claims Administrator’s customer service department will assist the Plan Participant if necessary. Send written Grievances to: United Concordia Dental Customer Service P.O. Box 69420 Harrisburg, PA 17106-9420 A response will be mailed to the Plan Participant within thirty (30) business days of receipt of the Plan Participant’s written Grievance.
Sample 1

Related to To File a Formal Grievance

  • Formal Grievance Step 1 6

  • Informal Grievance 1. Within fourteen (14) calendar days of the event giving rise to a grievance, the grievant shall present the grievance informally for disposition by the immediate supervisor or at any appropriate level of authority within the department. 2. Presentation of an informal grievance shall be a prerequisite to the institution of a formal grievance.

  • Filing a Grievance Grievances may be filed by the Union on behalf of an employee or on behalf of a group of employees. If the Union does so, it will set forth the name of the employee or the names of the group of employees.

  • Group Grievance Where a number of employees have identical grievances and each employee would be entitled to grieve separately they may present a group grievance in writing signed by each employee who is grieving to the Administrator or her designate within ten (10) days after the circumstances giving rise to the grievance have occurred or ought reasonably to have come to the attention of the employee(s). The grievance shall then be treated as being initiated at Step No. 1 and the applicable provisions of this Article shall then apply with respect to the processing of such grievance.

  • Statement of Grievance The grievance shall contain a statement of: 1. Specific situation, act or acts complained of as violation of this Agreement, or written rules, regulations or policies; 2. The damage suffered by the employee; and 3. The relief sought.

  • Policy Grievance – Union Grievance The Union may institute a grievance alleging a general misinterpretation or violation of this Agreement by the Employer by submitting a written grievance at Step No. 1 within twenty (20) days after the circumstances have occurred. This section shall not apply to disciplinary grievances or application of competitive clauses under this Agreement.

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

  • Individual Grievance Subject to clause 19.5 and as provided in section 208 of the PSLRA, an employee is entitled to present a grievance in the manner prescribed in clause 19.10 if the employee feels aggrieved (a) by the interpretation or application in respect of the employee, of (i) a provision of a statute or regulation, or a by-law, direction or other instrument made or issued by the Council, dealing with terms and conditions of employment; or (ii) a provision of a collective agreement or an arbitral award; or (b) as a result of any other occurrence or matter affecting the employee’s terms and conditions of employment.

  • Grievance Forms Forms for filing grievances, serving notices, taking appeals, reports and recommendations, and other necessary documents will be prepared jointly by the Superintendent or designee and the Association so as to facilitate operation of the grievance procedure. The costs of preparing such forms shall be borne by the Board.

  • Dismissal and Suspension Grievance All dismissals and suspensions will be subject to formal grievance procedure under Article 7 of this Agreement. A copy of the written notice of dismissal or suspension shall be forwarded to the President of the Union within five (5) days of the action being taken.

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