Provider Complaint definition

Provider Complaint. A written expression by a Provider, which indicates dissatisfaction or dispute with the Contractor’s policies, procedures, or any aspect of a Contractor’s administrative functions, including a Proposed Action.
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Provider Complaint means a provider’s complaint about the contractor’s performance. Verified provider complaints are used as a measure of the quality of the contractor’s performance under this SOW.
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Examples of Provider Complaint in a sentence

  • Providers who believe they are subject to such behavior by any agent of the State should first attempt resolution through the AFH Provider Complaint Resolution Process.

  • Disputes With Your Provider Complaint Resolution: Please contact your REP if you have specific comments, questions or complaints.

  • Section 8.4.2, CHIP Provider Complaint and Appeals, is modified to include the 30-day resolution requirement.

  • Provider Complaint – any verbal or written expression of dissatisfaction with any aspect of operations or activities of the MCO received by the MCO from a provider through any means regardless of whether the expression of dissatisfaction is resolved immediately, requires investigation and/or further actions, or does not require any remedial action.

  • Provider Complaint: A written expression by a Provider, which indicates dissatisfaction or dispute with the Contractor’s policies, procedures, or any aspect of a Contractor’s administrative functions.

  • Contractor must submit the Provider Complaint, Grievance, and Appeal policies and procedures to the DOM for review and approval forty-five (45) calendar days before implementation.

  • The Provider Complaint, Grievance, and Appeal policies and procedures shall be in accordance with the State’s Managed Care Quality Strategy, with the modifications that are incorporated in the Contract.

  • Contractor shall not modify the Provider Complaint, Grievance, and Appeal procedure without the prior approval of DOM, and shall provide DOM with a copy of the modification at least fifteen (15) calendar days prior to implementation.

  • Any Provider Complaint not resolved within one (1) business day shall be treated as a Grievance.

  • Party Action Time Frame Extensions Available Provider Complaint: An expression of dissatisfaction received orally or in writing that is of a less serious or formal nature that is resolved within one (1) business day of receipt.