Submitting a grievance Sample Clauses
The 'Submitting a grievance' clause outlines the process by which an individual or party can formally raise a complaint or concern within an organization or under a contract. Typically, this clause specifies the steps required to submit a grievance, such as providing written notice, identifying the issue, and following a designated chain of communication or procedure. Its core practical function is to ensure that grievances are addressed in an orderly and documented manner, providing a clear pathway for resolution and helping to prevent misunderstandings or escalation of disputes.
Submitting a grievance. If you have a question about your Benefits or any action taken by Blue Shield (or a Benefit Administrator), your first step is to make an inquiry through Customer Service. If Customer Service is not able to fully address your concerns, you can then submit a grievance or ask the Customer Service representative to submit one for you. If Blue Shield denies authorization or coverage for health care services, you can appeal the denial and Blue Shield will reconsider your request. You have 180 days after a denial or other incident to submit your grievance to Blue Shield. Your provider, or someone you choose to represent you, can also submit a grievance on your behalf. The fastest way to submit a grievance is online at ▇▇▇▇▇▇▇▇▇▇▇▇.▇▇▇. You can also submit the form by mail or begin the grievance process by calling Customer Service.