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How to file a
grievance at my provider agency?
A grievance is
a complaint or statement expressing concerns against a circumstance
thought to be unjust or injurious. Grievances are used to help
express the needs of the consumer as well as ensure that serious
concerns are addressed or taken care of by anyone who is receiving
services in PMHS.
PMHS in Frederick County has a number of
different provider agencies. MHMA respects that each provider
agency has well established grievance procedures. If a
consumer has a grievance with a provider, MHMA will not be involved
in the agency's internal handling of grievances. However,
provider agencies will inform MHMA in writing, if a grievance is
appealed to the final level of the provider agency's internal
grievance procedure.
Here are some examples of steps to
resolve your grievance with your provider
agency:
Step
1: If you feel you
have a grievance with your agency, the first step would be to report
the grievance to Case Manager, Counselor, Facilitator, Direct Care
Worker or Advocate within your agency. They should help you
review your agency's grievance procedure policy and help you express
or resolve your concerns with your agency.
Step 2: Report, in writing your grievance to the
Supervisor, Director or Head of that Department. Some agencies
have a standardized grievance report form to fill out. Ask the
individual's that you are working with where these forms may be
located. Your grievance should be filed and someone should
meet with you to discuss your grievance. If you are
unsatisfied with the results of the grievance and feel you have not
had a resolution you can move on to the next
step.
Step
3: Report, in
writing, your grievances to the Executive Director of the
Agency. Request a meeting with you and the director to discuss
your grievance. If you still feel unsatisfied you may move on
to the next step.
Step 4: You may ask MHMA for assistance if you feel that your
grievance has still not been resolved to your satisfaction within
the provider's internal grievance procedure.
If you feel that
you need help with navigating through the provider grievance
procedures, you may request assistance from MHMA. MHMA will
connect you with an advocate who can help you through the provider's
internal grievance procedures.
Click here to
see flow chart of these steps.
How to file a Grievance
with MHP for Denial of Services?
Maryland Health
Partners (MHP) authorizes the services that you request for an
agency you work with. If you are denied services and you
disagree with the decision, MHP has an appeal process consisting of
two levels. Follow these steps to file an
appeal.
Step
1: If you receive a
denial of service from MHP in the mail you may appeal this.
Call MHP at 1-800-888-1965. Request an appeal to this
decision. The first appeal level is with MHP's staff
psychiatrist, who will make the determination. If you still
disagree you may go to the next step.
Step 2: Ask for a determination from the medical
director. If you are still unsatisfied with the decision you
may go on to the next step.
Step 3: You may file the third level appeal with MHP asking
that the appeal be forwarded to the Director of Mental Health
Programs at MHMA.
Click here to see
flow chart of these steps
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