How to File a Grievance in PMHS

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

Other Pages……..
How to File a Grievance
Financial Forms
Glossary and Abbreviations