Contract

Qorshahaaga caymiska caafimaadka ee UCare wuxuu ku siinayaa isuduwidda daryeelka weliba lacag la'aana. Iskuduwaha daryeelkaaga ayaa halkan u jooga inuu kaa taageero baahiyahaaga caafimaad, bulsho, iyo baahiyahaaga maalinlaha ah. Waxay gacan ka gaysan karaan inaad caafimaad qab iyo badbaado ku joogto gurigaaga.

Goorta Ay Tahay In Lala Xxxxxxx Xxxxxxxxxx Daryeelkaaga

Xxxxxxxxxx Xxxxxxxxx

Magaca isuduwaha daryeelkayga waa:

Taleefanka: Iimaylka:

Isku-duwayaasha daryeelka ayaa bixiya:

• waxbarashada caafimaadka

• U-doodid

• Gudbin

• garaadka ee u baahan

• Caawimaad la xiriirta daryeelka

• Barashada gunnada

Macluumaadka Gunnada	Marka aadan xxxxx waxa gunnooyinkaaga ay yihiin Markaad u baahato macluumaadka ku saabsan gunnooyinka caymiskaaga UCare, iskuduwaha daryeelkaaga ayaa kaa caawin kara. Waxay wax kaaga sheegi karaan barnaamijyada iyo taageerada aad u baahan karto si aad u wanaajiso caafimaadkaaga.
	• Helitaanka gunnooyinka • Barnaamijyada waxbarashada jirdhiska bulshada • Taageerada maaraynta • Ka hadlitaanka gunnooyinka cudurka dheeraadka ah

Marka aad u baahan tahay caawimaad ku aadan raadinta/helitaanka daryeel caafimaad iyo taageerooyin kale Isuduwaha daryeelkaaga ayaa kaa caawinaya inaad hesho daryeel caafimaad oo takhasus leh. Waxay sidoo kale kugu hagaajin karaan Daryeel-bixiye Aasaasi ah.

• Inay ku siiyaan xulashooyinka laga dhex helo shabakadda

• Helitaanka adeeg- bixiyeyaasha ilkaha

• Caawimaad ku aadan ballan u qabsashada daryeelka caafimaadka ka-hortagga ah

•

•

•

Helitaanka gaadiid lagu aadayo ballamaha caafimaadka

Helitaanka daryeelka caafimaadka dhimirka iyo isticmaalka mukhaadaraadka Iskudubaridka qalabyada iyo agabyada caafimaadka ee uu kuu dalbay adeeg- bixiyahaaga

Ma u Baahan Tahay Daryeel

Daryeelka Guriga Dhexdiisa ah

Marka aad u baahan tahay in adeegyo laguugu hagaajiyo gurigaaga

Iskuduwaha daryeelkaaga wuxuu kaala hadlayaa baahiyahaaga. Waxay kuu sheegayaan xulashooyinkaaga iyo kheyraadka. Iskuduwaha daryeelkaaga wuxuu kaa caawinayaa wixii gudbin ah iyo isku-dubaridka adeegyada.

• Daryeelka guriga / Kalkaalinta Xirfada Leh

• Teerabiyada Xxxxx & Shaqada Jirka

• Hagaajinta adeegyada bukaan-socodka

• Daryeelka caafimaadka guriga

• PCA

• Adeegyada

xxxx-xxxxxxxxxx & xxxxxxxxxxx xxxxxx

• U gudbinta kheyraadka guriyeynta, cuntada iyo bulshada

• Taageerada caafimaadka dhimirka

Isbitaalka Lagu Dhigo

Marka isbitaalka lagu dhigo

Iskuduwaha daryeelkaaga ayaa halkan kuu jooga marka caafimaadkaaga uu is beddelo ama marka isbitaal lagu dhigo. Waxay:

• Kuu raadinayaan adeegyada iyo taageerooyinka loo baahan yahay si aad ugu laabato ama aad u joogtid gurigaaga

• Kuu raadinayaan gaadiid aad ku aado ballamaha caafimaadka si aad u hesho daryeel dabagal ah

• Kaa taageerayaan u gudbinta Guriga & Adeegyada Bulshada Ku Salaysan

• Kaa caawinta inaad hesho xaalad nololeed oo xxxxx

• Xxxx hadlida siyaabaha aad bannaanka uga joogi karto isbitaalka

Haddii xaaladaadu tahay mid nafta halis galinaysa, aad ER. Waxaad sidoo kale wici kartaa 911 isla markiiba.

UCare’s MSHO (HMO D-SNP) waxaa weeye caymis caafimaad oo heshiis kula jira barnaamijka Medicare iyo Kaalmada Caafimaad ee Minnesota (Medicaid) si ay uga helaan kaalmo gunooyin ah oo labada barnaamijba ah dadka ku jiraayi. Iska diiwaangelinta UCare’s MSHO waxay ku xidhan tahay dib u cusboonaysiinta heshiiska.

H2456_11962_072022

accepted H5937_11962_072022_C

U11962 (07/2022)

Xxxxxx Xxxxxxxxx ah 0-000-000-0000, TTY 0-000-000-0000

Ogaysiiska Xuquuqda Madaniga ah

CBS (MCOs) (10-2021)

Takoorka ku lidka ah sharciga. UCare uma takoorto qaabka wax soosocda ah:

• isir • da’da • caqiidada diimeed

• midab • naafanimada (ay ku jirto jidh • xaalada caafimaad

• asalka qaranka ahaaneedl ama maskax • heerka caafimaadka

• caqiiqda ahaan liidashada • xxxxxx daryeelka caafimaadka

• diinta

• qaabka galmada

• heerka caawimada dadwaynaha

• jinsiga (oo ay ku jiraan fikradaha jinsiga iyo aqoonsiga jinsiga)

• heerka guurka

adeegyada

• sheegashooyinka waayo aragnimada

• taariikhda caafimaadka

• macluumaadka hide-sidaha

Waxaad xaq u leedahay in aad xaraysato cabasho takoorid haddii aad aaminsantahay in UCare laguula dhaqmay si takoor ah. Xxxxxx xaraysan kartaa cabasho oo aad codsan kartaa xaraynta cabasho shakhsi ahaaneed ama boosto, telefoon, fakis, ama iimayl xxxxx:

UCare

Attn: Appeals and Grievances PO Box 52

Minneapolis, MN 55440-0052

Xxxxxx Xxxxx-la'aan ah: 0-000-000-0000 TTY: 0-000-000-0000

Fakis: 000-000-0000

Iimayl: xxx@xxxxx.xxx

Qalabka Kaalmada ah iyo Adeegyada: UCare waxay bixiyaan qalabka iyo kaalmada, sida turjubaanada takhasuska leh ama macluumaadka gudaha qaababka la gaadhi karo, bilaashka ah iyo wakhtiga habboon ah si loo xaqiijiyo fursada loo siman yahay in laga qayb galo barnaamijyada daryeelka caafimaadka. Kala xidhiidh UCare lambarka 000-000-0000 (codka) ama

0-000-000-0000 (codka), 000-000-0000 (TTY), ama 0-000-000-0000(TTY).

Adeegyada Kaalmada Luqadda: UCare waxay bixiyaan dhokumentiyada turjuman iyo luqadda lagu hadlo ee turjumaada, bilaahska ah iyo wakhtiga habboon,marka adeegyada kaalmada luqadda ay lama huraan yihiin in la xaqiijiyo ku hadlayaasha Ingiriisiga xadidan inay helitaan macno buuxa leh u helaan macluumaadkayaga iyo adeegyada. Kala xidhiidh UCare lambarka

000-000-0000 (codka) ama 0-000-000-0000 (codka), 000-000-0000 (TTY), ama

0-000-000-0000(TTY).

Cabashooyinka Xuquuqda Madaniga ah

Waxaad xaq u leedahay in aad xaraysato cabasho takooridhaddii aad aaminsantahay in UCare laguula dhaqmay si takoor ah. Waxaad sidoo xxxx xxx xidhiidhi kartaa mid kasta oo ka mid ah wakaaladaha soo socda si toos ah si aad u soo xarayso cabashada takoorka.

Waaxda Maraykanka ee Caafimaadka iyo Xafiiska Adeegyada Aadanaha ee Xuquuqda Madaniga (OCR) Waxaad xaq u leedahay inaad cabasho ka xaraysato OCR, wakaalad federaali ah hadii aad aaminsantahay Waxaa lagugu takooray mid ka mid ah kuwan soo socda:

CBS (MCOs) (10-2021)

• isir

• midab

• asalka qaranka

• da'da

• naafanimada

• sinjiga

• diin (xaaladah qaarkood)

Si toos ah ula xiriir OCR si aad u xarayso cabasho: Office for Civil Rights

U.S. Department of Health and Human Services Midwest Region

233 N. Xxxxxxxx Xxxxxx, Xxxxx 000

Chicago, IL 60601

Xarunta Jawaab celinta Macmiilka: Xxxxxx Xxxxx la'aanta ah: 000-000-0000 TDD Xxxxxx Xxxxx la'aanta ah: 000-000-0000

Iimayl: xxxxxxx@xxx.xxx

Waaxda Minnesota ee Xxxxxxxx Xxxxxxxx (MDHR)

Minnesota gudaheeda, waxaad xaq u leedahay inaad cabasho u gudbiso MDHR haddii lagugu takooray mid ka mid ah kuwan soo socda:

• isir

• midab

• asalka qaranka

• diinta

• caqiidada

• sinjiga

• qaabka galmada

• heerka xxxxxx

• xxxxxx caawimada dadwaynaha

• naafanimada

Xxx xxxxxxxx MDHR si toos ah sidaad cabasho ugu soo xarayso: Minnesota Department of Human Rights

000 Xxxxxxxx Xxxxxx Xxxxx, Xxxxx 000 Xx. Xxxx, MN 55104

000-000-0000 (codka)

000-000-0000 (bilaash ah)

711 ama 000-000-0000 (MN Relay)

000-000-0000 (fakis)

xxxx.XXXX@xxxxx.xx.xx (iimayll)

Waaxda Minnesota ee Adeegyada Aadamaha (DHS)

Waxaad xaq u leedahay inaad xaraysato cabasho DHS haddii aad aaminsantahay in lagugu takooray barnaamijyadayada daryeelka caafimaadka mid ka mid ah kuwan soo socda:

• isir

• midab

• asalka qaranka

• diin (xaaladah qaarkood)

• da'da

• naafanimada (ay ku jirto liidashada jidhka ama maskaxda)

• jinsiga (oo ay ku jiraan fikradaha jinsiga iyo aqoonsiga jinsiga)

CBS (MCOs) (10-2021)

Cabashooyinka waa inay ahaadaan qoraal waana in la soo gudbiyaa 180 maalmood gudahooda laga bilaabo taariikhda aad ogaatay takoorka qofka lagu eedeeyay. Cabashada waa inay ka kooban tahay magacaaga iyo cinwaankaaga waana inay sharaxaad ka bixisaa takoorka aad ka cabanayso. Dib u eegis ayaan ku samayn doonaa oo qoraal ahaan ayaan kugu soo ogeysiin doonaa haddii aanu awood u leenahay inaanu baari karno iyo haddii kale.Haddii aanu baari karno, waxaanu baaritaan ku samayn doonaa cabashada.

DHS ayaa waxay qoraal ahaan kugu soo ogaysiin doonta natiijada baaritaanka. Waxaad xaq u leedahay inaad racfaan ka qaadato haddii aanad ku raacsanayn go'aanka. Si aad rafcaan u qaadato waa inaad codsi qoraal ah soo dirtaa si DHS ay dib u eegis ugu samayso natiijada baaritaanka. Xxx xxxx oo sheeg sababta aad u diiday go’aanka. Ku dar wixii macluumaad dheeraad ah oo aad u malaynayso inay muhiim tahay.

Haddii aad dacwad u soo gudbiso qaabkaan, dadka u shaqeeya Tani waxaa loola jeedaa inaysan sinaba kuu ciqaabi xxxxx sabab la xiriirta inaad cabasho gudbisay. Xxxxx xxxxxxx u soo gudbiso qaabkaan kaama hor istaagayso inaad raadsato talaabooyin kale oo sharciyeed ama maamuleed.

Si toos ah ula xiriir OHS si aad u gudbiso cabasho la xiriirta takoor: Xxxxxxxxxx Xxxxxxxx Xxxxxxxx ah

Waaxda Adeegyada Aadanaha ee Minnesota Qaybta Fursadaha loo siman yahay iyo Helitaanka

P.O. Box 64997

ST. Xxxx, MN 55164-0997

000-000-0000 (cod) ama isticmaal adeegga gudbinta ee aad doorbidayso