Grievances and Appeals
A Grievance is a 45-day process, with up to a 14-day extension to find a resolution.
You can file a grievance if you aren’t happy with the way you were treated, the quality of care or services you received or if you have problems getting care. (If you were denied, suspended, or terminated from a service, this would be an action, and you would need to file an Appeal).
A grievance is filed at the payment source. If you have Medicaid Behavioral Health Services, it will be filed at your MCO (Managed Care Organization) Plan. If your grievance involves Crisis Service, State-funded Services or Non-Medicaid Services, your grievance will be filed at TM BH-ASO.
The Ombuds can help you navigate the grievance process with a signed and dated Release of Information and Authorization for Representation giving the MCO or ASO permission to include Ombuds with any letters, timelines, meetings or resolutions.