![]() You can call the MassHealth Customer Service Center at (800) 841-2900. They can help you apply for MassHealth, give information about your health plan benefits, or help you replace a lost MassHealth member ID card. For example, they can provide information about your eligibility for MassHealth coverage and help you enroll in a MassHealth health plan. The MassHealth Customer Service Center can help all MassHealth members, not just members of MassHealth health plans, with a wide range of questions and concerns. ![]() We are an independent program run by a non-profit organization. When you contact My Ombudsman, the person you talk to is not a MassHealth employee. My Ombudsman is not a part of MassHealth or any health plan. We can’t represent you in an appeal, which means we can’t serve as your advocate and tell MassHealth or your health plan to make a decision in your favor. My Ombudsman can help you understand why your service was denied, explore your choices, and help you navigate the process of an appeal or grievance. ![]() The plan is still required to respond (usually in writing) to your concerns. This type of complaint is a way to get your concerns “on the record,” but it may not result in a different outcome or change their decision. The provider who requested the service or care that was denied can also help with this process.Ī grievance is a formal way of telling your health plan that you are not happy with their actions. When you file an appeal, you get to tell your health plan or MassHealth in your own words why you disagree with their decision. In general, you have the right to file an appeal or a grievance.Īn appeal is an official way of asking your health plan (or in some cases MassHealth) to change a decision. My Ombudsman can work with you one-on-one to discuss your rights and choices if you disagree with a coverage decision your health plan made.
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