GRIEVANCE AND APPEAL PROCEDURES. 12. The INSURER, its agents, any contractor or sub-contractor party under this contract shall not engage in cold call marketing that is, unsolicited personal contact with potential enrollees for the purpose of influencing them to enroll with any of its contractors. Also telephone, door-to-door or telemarketing for the same purposes is hereby prohibited.
GRIEVANCE AND APPEAL PROCEDURES. A. In the event of a member grievance, the Contractor shall attempt to resolve the complaint informally and instruct the member to contact the OHCA’s Legal Division if the member wishes to file a written grievance.
GRIEVANCE AND APPEAL PROCEDURES. 24.1.1 The purpose of this procedure is to secure, in an atmosphere of courtesy and cooperation and at the lowest possible administrative level, an equitable solution to the problems which may arise. A grievance, as well as any subsequent appeal, should first be discussed with the aggrieved person’s immediate supervisor with the objective of resolving the matter informally.
GRIEVANCE AND APPEAL PROCEDURES. The Contractor shall establish and maintain a procedure for the receipt and prompt internal resolution of all grievances and appeals in accordance with S.C. Code Xxx. §00-00-000 (Supp. 2002) as amended and 42 C.F.R. Section 438.400, et seq. The Contractor's grievance and appeals procedures and any changes thereto must be approved in writing by SCDHHS prior to their implementation and must include at a minimum the requirements set forth herein. The Contractor shall refer all Medicaid MHN program members who are dissatisfied with the Contractor or its subcontractor in any respect to the Contractor's designee authorized to require corrective action. In all cases, where the member has a grievance about treatment by the Contractor, or its subcontractor, the member must exhaust the Contractor's internal grievance/appeal procedures prior to accessing the State’s Fair Hearing process. If the member is grieving a disenrollment issue, the Contractor’s grievance process must be completed in time to permit the disenrollment, if approved, to be effective in accordance with the timeframe specified in 42CFR 438.56(e)(1). If as a result of the grievance process the Contractor approves the disenrollment, the State shall not be required to make a determination.
GRIEVANCE AND APPEAL PROCEDURES. 1. In accordance with ATTACHMENT V, Minimum Guidelines for Recipient Grievance Procedures, the recipient will assure through contractual provisions that subrecipients have procedures for handling complaints from Medicaid Waiver clients persons who complain service has been denied, terminated or reduced.
GRIEVANCE AND APPEAL PROCEDURES. State [State Contract Article VII.F5] 27
GRIEVANCE AND APPEAL PROCEDURES. We want to know when You are dissatisfied about the care or services received from Blue Cross and Blue Shield of Louisiana, United Concordia Dental (UCD), or Participating Providers. If You want to register a Complaint or file a formal written Grievance about Us, UCD or a Provider, please refer to the procedures below. You may be dissatisfied about decisions made regarding Covered Services. UCD considers an Appeal as Your written request to change an Adverse Benefit Determination. Your Appeal rights are outlined below, after the Complaint and Grievance procedures. There is an Expedited Appeals process for situations where the time frame of the standard Dental Necessity Appeal would seriously jeopardize the life or health of a covered person or would jeopardize the covered person’s ability to regain maximum function.
GRIEVANCE AND APPEAL PROCEDURES. The College and the Union recognize the importance of orderly and peaceful labor relations for the mutual interest and benefit of the College, Employees, and the Union. The College and the Union further recognize the mutual benefits of just and expeditious resolution of disputes which may arise as to proper interpretation and implementation of this CBA and accordingly, have included herein grievance and appeal procedures for the effective process and resolution of such disputes. Definitions/Assumptions Informal Resolution: The parties acknowledge that it is preferable for an Employee and the College to resolve problems through free and informal communications prior to the filing of a grievance. Bypass: By mutual written agreement, any step of the grievance procedure may be bypassed. No Reprisals Clause: No reprisals shall be taken by the College or the Union against any Employee because of the Employee’s filing of a grievance.
GRIEVANCE AND APPEAL PROCEDURES. The following arrangements have been made with regard to grievance and appeals: [insert from proposal template] EXAMINATION, GRADUATION AND TESTAMUR
GRIEVANCE AND APPEAL PROCEDURES. In accordance with ATTACHMENT V, The recipient will ensure through agreement provisions that sub-recipients and vendors follow the Minimum Guidelines for Recipient Grievance Procedures, ATTACHMENT V, for handling complaints from persons who complain service has been denied, terminated or reduced Medicaid Waiver Clients. [←not new language-moved from IV. C.] Recipients and subrecipients will establish complaint procedures for older consumers who are dissatisfied with or denied services. These procedures must include notice of the right to complain and to have their complaint reviewed. [←not new language-moved from IV. C.]
