COMPLAINT or GRIEVANCE definition

COMPLAINT or GRIEVANCE means an expression of dissatisfaction about any matter other than an action, as defined above. As provided by 42 C.F.R. Section 438.400, possible subjects for complaints or grievances include, but are not limited to, the quality of care of services provided, and aspects of interpersonal relationships such as rudeness of a provider or employee, or failure to respect the Member's rights. EMERGENCY MEDICAL CONDITION, means a medical condition manifesting itself by acute symptoms of recent onset and sufficient severity (including severe pain), such that a prudent layperson, who possesses an average knowledge of health and medicine, could reasonably expect the absence of immediate medical care could result in:
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Related to COMPLAINT or GRIEVANCE

  • A grievance means a dispute or disagreement as to the interpretation or application of terms and conditions of employment contained in this Agreement.

  • Grievance means a complaint in writing that an employee, group of employees, or the Union submits to management, to be processed through the grievance procedure.

  • Group Grievance is defined as a single grievance, signed by a ▇▇▇▇▇▇▇ or a Union Representative on behalf of a group of employee who have the same complaint. Such grievances must be dealt with at successive stages of the Grievance Procedure commencing with Step 1. The grievors shall be listed on the grievance form.

  • Policy Grievance shall be signed by a ▇▇▇▇▇▇▇ or a Union representative or, in the case of an Employer's policy grievance, by the Employer or its representative.

  • Complaint means any dissatisfaction expressed by a Complainant orally or in writing to HMO about any aspect of HMO’s operation, including, but not limited to: