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MEMBER’S RIGHT TO FILE A COMPLAINT, GRIEVANCE OR DHS HEARING

Members must be informed of their right to file a complaint, grievance, or DHS Fair Hearing, as well as any changes to those rights. You are forbidden from retaliation in any way. If a member needs additional assistance, they may contact an ombudsman in their county. All services provided by an ombudsman are free of charge and confidential. A list of telephone numbers for the ombudsman is provided on the Liên hệ thành viên page of this website.

A training outlining what to expect from Carelon if a complaint is filed against your organization is available on the Provider Training page under the Quality Management section. For a detailed description of the complaint, grievance, and fair hearing processes, please refer to Appendix AA and Appendix H.

For a detailed description of the complaint, grievance, and fair hearing processes, please refer to Phụ lục AAPhụ lục H.