TABLE 21-6, FIRST-LEVEL MEMBER GRIEVANCE |
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COMMERCIAL AND MEDICARE PLANS |
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BENEFIT PLAN(S) |
WHAT/HOW/WHERE TO FILE: INSTRUCTIONS |
TIME FRAMES |
ADDITIONAL RIGHTS |
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Initial Member Filing |
ConnectiCare Acknowledges Receipt |
ConnectiCare Determination Notification |
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ConnectiCare |
Write to: ConnectiCare Telephone: |
60 calendar days for Medicare and 180 calendar days for commercial from receipt of |
3 business days for commercial and 15 calendar days for Medicare from receipt of the grievance |
30 calendar days (plus possible 14 day extension) for Medicare and 20 business days for commercial from receipt of the grievance |
N/A |
ConnectiCare of Massachusetts |
Unless otherwise directed in the denial letter, write to: ConnectiCare Telephone: |
60 calendar days for Medicare and 180 calendar days for commercial from receipt of |
15 calendar days for commercial from receipt of the grievance |
30 calendar days from receipt of grievance |
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Member Grievance – First-Level Process Table
