Grievance and Appeal System Reporting Clause Samples

Grievance and Appeal System Reporting. The MCO must submit the Appeal and Grievance Activity Report to ODM as specified in Appendix P, Chart of Deliverables. The MCO must submit appeal and grievance activity at least monthly in an electronic data file format pursuant to the ODM Appeal File and Submission Specifications and ODM Grievance File and Submission Specifications.
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Grievance and Appeal System Reporting. The MCO must submit the Appeal and Grievance Activity Report to ODM as specified in Appendix P, Chart of Deliverables. The MCO must submit appeal and grievance activity at least monthly in an electronic data file format pursuant to the ODM Appeal File and Submission Specifications and ODM Grievance File and Submission Specifications. The MCO must submit the Quarterly Grievance and Appeal Summary Report to ODM as specified in Appendix P, Chart of Deliverables. As part of the MCO's report submission, the MCO must include the analysis of individual and aggregate outliers and trends and identify the MCO's actions taken in response.
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Grievance and Appeal System Reporting i. The OhioRISE Plan must submit the Grievance and Appeal Activity Report to ODM as specified in Appendix P, Chart of Deliverables. The OhioRISE Plan must submit appeal and grievance activity at least monthly in an electronic data file format pursuant to the ODM ii. The OhioRISE Plan must submit the Monthly Grievance and Appeal System Report to ODM as specified in Appendix P, Chart of Deliverables. The OhioRISE Plan must submit grievance, appeal, and state hearing information as required in ODM's Grievance,
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Grievance and Appeal System Reporting i. The OhioRISE Plan must submit the Grievance and Appeal Activity Report to ODM as specified in Appendix P, Chart of Deliverables. The OhioRISE Plan must submit appeal and grievance activity at least monthly in an electronic data file format pursuant to the ODM Appeal File and Submission Specifications and
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Related to Grievance and Appeal System Reporting

  • CHILD ABUSE REPORTING CONTRACTOR hereby agrees to annually train all staff members, including volunteers, so that they are familiar with and agree to adhere to its own child and dependent adult abuse reporting obligations and procedures as specified in California Penal Code section 11164 et seq. and Education Code 44691. To protect the privacy rights of all parties involved (i.e., reporter, child and alleged abuser), reports will remain confidential as required by law and professional ethical mandates. A written statement acknowledging the legal requirements of such reporting and verification of staff adherence to such reporting shall be submitted to the LEA.

  • 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.

  • GRIEVANCE REPORT FORM Grievance # School District Distribution of Form 1. Superintendent