Member Information -
Filing an Appeal with Your MCO
If you received a notice of action for a termination, denial or
reduction of services and you disagree with this decision you can appeal.
You have the right to appeal to your MCO's Grievance and Appeals
Committee. You can appear in person, if you choose. You can bring an
advocate, friend, family member or witness. You may also present evidence
to this committee.
It is your right to file an appeal but you could also contact your Care
Manager or the Member Rights Specialist to informally resolve the concern.
Informal resolution is typically quicker and more beneficial for you.
To file an appeal with the MCO's Grievance and Appeals Committee,
contact your Care Manager or the Member Rights Specialist. You can also
start the process by submitting a request form. Please select the request
form for the your MCO.
Note: the forms are MS Word fillable. Microsoft Word - Fillable forms,
can be filled in, saved, and transmitted electronically. You must
have access to Microsoft Office 97, or a more recent version, to use these
January 07, 2014