If you received a notice of adverse benefit determination for a termination, denial, or reduction of your services and you disagree with this decision you can appeal. You have the right to appeal to your managed care organization's grievance and appeal committee. You can appear in person, if you want. You can bring an advocate, friend, family member, or witness. You can also present evidence to this committee.
It is your right to file an appeal, but you want to contact your care manager or the member rights specialist first to informally resolve your concern. Informal resolution is typically quicker and more beneficial for you.
To file an appeal with your managed care organization's grievance and appeal committee, contact your care manager or the member rights specialist. You can also start the process by filling out and sending in a request form. Please select the request form for your managed care organization.
|Managed Care Organization||Language|
|Care Wisconsin, F-00237 (Word)||English|
|Community Care, Inc., F-00237 (Word)||English|
|Inclusa, Inc., F-00237 (Word)||English|
|iCare (Independent Care Health Plan), F-00237 (Word)||English|
|Lakeland Care, Inc., F-00237 (Word)||English|
|My Choice Family Care, F-00237 (Word)||English|