Grievance and Appeals Unit See Section 9 for contact information. You may also contact the Office of the Health Insurance Commissioner’s Consumer Resource Program, RIREACH at 1-855-747-3224 about questions or concerns you may have. A complaint is an expression of dissatisfaction with any aspect of our operation or the quality of care you received from a healthcare provider. A complaint is not an appeal. For information about submitting an appeal, please see the Reconsiderations and Appeals section below. We encourage you to discuss any concerns or issues you may have about any aspect of your medical treatment with the healthcare provider that furnished the care. In most cases, issues can be more easily resolved if they are raised when they occur. However, if you remain dissatisfied or prefer not to take up the issue with your provider, you can call our Customer Service Department for further assistance. You may also call our Customer Service Department if you are dissatisfied with any aspect of our operation. If the concern or issue is not resolved to your satisfaction, you may file a verbal or written complaint with our Grievance and Appeals Unit. We will acknowledge receipt of your complaint or administrative appeal within ten (10) business days. The Grievance and Appeals Unit will conduct a thorough review of your complaint and respond within thirty (30) calendar days of the date it was received. The determination letter will provide you with the rationale for our response as well as information on any possible next steps available to you. When filing a complaint, please provide the following information: • your name, address, member ID number; • the date of the incident or service; • summary of the issue; • any previous contact with BCBSRI concerning the issue; • a brief description of the relief or solution you are seeking; and • additional information such as referral forms, claims, or any other documentation that you would like us to review. Please send all information to the address listed on the Contact Information section.
Appeals Process (a) The incumbent(s), the designated manager, ▇▇▇▇▇▇▇ or the Employer, can appeal Joint Job Evaluation Committee decisions for existing positions. (b) Appeals may be filed based on the following criteria: (i) The evaluation results are not consistent with the benchmarks, or (ii) Extenuating circumstances, or (iii) A violation of Article 14 of the Collective Agreement. (c) If an incumbent and/or designated manager decides to appeal a Joint Job Evaluation Committee’s decision, their intent to appeal must be submitted by email or written notification to the Compensation Office within ten (10) working days of receipt of the Evaluation Report. (d) If YusApuY or the Employer appeals a Joint Job Evaluation Committee’s decision, it must be submitted by email or written notification to the Employer or YusApuY within ten (10) working days of receipt of the Evaluation Report. (e) Incumbent(s), the designated manager, YusApuY and the Employer shall be notified within five (5) working days of any submitted appeal of a Joint Job Evaluation Committee’s decision. (f) YusApuY and the Compensation Office shall each prepare a written rationale within six (6) months of the appeal being initiated. The rationale shall be based only on the Job Evaluation Questionnaire and related information submitted to the Joint Job Evaluation Committee and shall identify criteria for appeal, the evaluation factor level(s) the Party(s) is appealing/responding to, and the recommended evaluation factor level(s) with supporting justification. (g) A Joint Appeals Committee shall consider an appeal of an evaluation decision made by a Joint Job Evaluation Committee based on the following process: (i) The Joint Appeals Committee shall have access to: all information provided to the Joint Job Evaluation Committee(s); all documentation prepared by the Joint Job Evaluation Committee and written appeal rationale documentation. (ii) Based on all information provided, the Joint Appeals Committee shall determine if there are sufficient grounds to assign a different level to the appealed factor(s), or confirm the factor level(s) assigned by the Joint Job Evaluation Committee. If the Joint Appeals Committee determines that clarification of submitted information is required, the Committee shall interview the incumbent and the designated manager. (iii) The Joint Appeals Committee shall have the right to override any evaluated factor established by the Joint Job Evaluation Committee. (iv) The Joint Appeals Committee shall make a decision within three (3) months of the submission of the written rationales per Article 14.08(f). (v) Joint Appeals Committee decisions shall be made by consensus and shall be final and binding on both Parties. When consensus is not reached, then the appeal and all submitted documentation shall be directed to a Labour/Management committee for binding resolution.
Approval of Plans and Specifications The Plans and Specifications will conform to the requirements and conditions set out by applicable law or any effective restrictive covenant, and to all governmental authorities which exercise jurisdiction over the Leased Premises or the construction thereon.