Provider Manual - Carelon-PA

BEHAVIORAL HEALTH ADMINISTRATIVE COMPLAINTS

行政投诉是指除会员以外的任何人以书面或口头形式提出的与提供者、政府实体、机构或管理式护理组织相关的任何投诉。行政投诉不是请求重新授权服务或重新确定付款。会员不得提出行政投诉。

Behavioral health administrative complaints may be initiated either by telephone on the toll-free provider line at 877-615-8503 or in writing addressed to:

Carelon Health of Pennsylvania
邮政信箱1840
蔓越莓镇，宾夕法尼亚州16066-1840
注意投诉调查员 

要么

Behavioral health administrative complaints may also be faxed to the Quality Management Department (855-287-8491).

Carelon-PA will document and work to resolve all administrative complaints within thirty (30) calendar days of receipt. If a complaint cannot be handled at the first point of contact, it will be assigned to a Complaint Investigator to resolve the complaint in an expedient manner. A letter outlining the resolution of the initial complaint will be sent to the complainant when the resolution of the complaint is accomplished, or within five (5) business days after the initial thirty (30) calendar days allocated for the complaint resolution, whichever comes first.