Grievance System definition
Grievance System means the overall system that includes:
Grievance System means the overall system that includes grievances and appeals handled by the Contractor and access to the hearing system (42 CFR 438, Subpart F).
Grievance System means the overall system that includes Grievances and Appeals handled at the MCO and access to the State Fair Hearing process.
Examples of Grievance System in a sentence
The result of the Covered Person claim dispute process shall be binding on Provider, per State Medicaid Grievance System requirements.
For this Appendix, State Medicaid Grievance System means Arizona Administrative Code Title 9 Chapter 34 et.
Grievance System – includes a grievance process, an appeals process, and access to the State’s fair hearing system.
The MAO shall submit Grievances and Appeals reports in accordance with the requirements of Attachment 1: Chart of Deliverables and the AHCCCS Grievance System Reporting Guide.
The Grievance System must include Grievances and Appeals related to requests for accommodation in communication or provision of services for Members with a disability or limited English proficiency.
More Definitions of Grievance System
Grievance System. The overall system that includes Grievances and Appeals at the Contractor level and access to the State Fair Hearing process (the State’s Administrative Law Review).
Grievance System. The system for reviewing and resolving Enrollee Grievances and Appeals. Components must include a Grievance process, an Appeal process and access to the Medicaid Fair Hearing system.
Grievance System means the processes through a BHO in which an Individual applying for, eligible for, or receiving behavioral health services may express dissatisfaction about services. The grievance system must be established by the BHO, must meet the requirements of 42 CFR § 438 Subpart F, and include:
2.39.1 A grievance process;
2.39.2 An appeal process: and 2.39.3 Access to the Department's Fair Hearing process.
Grievance System. The system for reviewing and resolving enrollee complaints, grievances and appeals. Components must include a complaint process, a grievance process, an appeal process, access to an applicable review outside the Health Plan (Subscriber Assistance Program or Beneficiary Assistance Program), and access to a Medicaid Fair Hearing through the Department of Children and Families.
Grievance System means the overall system that includes grievances and appeals handled at the MCO level and access to the agency's hearing process.
Grievance System. The overall system that address the manner in which the CMO handles Grievances at the Contractor level.
Grievance System means the overall system that includes: (a) Grievances to a managed care entity (MCE) on matters other than adverse benefit determinations; (b) Appeals to an MCE on adverse benefit determinations; and (c) Contested case hearings through the OHA on adverse benefit determinations and other matters for which the member is given the right to a hearing by rule or statute