TABLE 21-4, SECOND LEVEL MEMBER COMPLAINT - EXPEDITED | |||||
COMMERCIAL AND CHILD HEALTH PLUS PLANS | |||||
BENEFIT PLAN(S) |
WHAT/HOW/WHERE TO FILE |
TIME FRAMES |
ADDITIONAL RIGHTS |
||
Initial |
EmblemHealth Acknowledges Receipt |
EmblemHealth Determination Notification |
|||
HIP Commercial, |
Write to: EmblemHealth Telephone: |
60 business days from receipt of first level |
N/A |
2 business days from receipt of necessary |
Additional complaints may be filed with the NYS DOH at any time by calling |
GHI HMO |
Write to: GHI HMO Telephone: TTY/TDD: 711 Fax to: |
60 business days from receipt of first level |
N/A |
2 business days from receipt of necessary |
Additional complaints may be filed with the NYS DOH at any time by calling |
GHI and |
Write to: EmblemHealth/GHI Telephone: |
60 business days from receipt of first level |
N/A |
2 business days from receipt of necessary information. |
Decision is final. |
TABLE 21-5, SECOND LEVEL MEMBER COMPLAINT - STANDARD |
|||||
COMMERCIAL AND CHILD HEALTH PLUS PLANS | |||||
BENEFIT PLAN(S) |
WHAT/HOW/WHERE TO FILE |
TIME FRAMES |
ADDITIONAL RIGHTS |
||
Initial Member Filing |
EmblemHealth Acknowledges Receipt |
EmblemHealth Determination Notification |
|||
HIP Commercial, |
Write to: EmblemHealth Telephone: |
60 business days from receipt of first level |
15 business days from receipt of the request. |
30 business days from receipt of all necessary |
Additional complaints may be filed with the NYS DOH at any time by calling |
GHI HMO |
Write to: GHI HMO Telephone: TTY/TDD: 711 Fax to: |
60 business days from receipt of first level |
15 business days from receipt of the request. |
30 business days from receipt of all necessary |
Additional complaints may be filed with the NYS DOH at any time by calling 1-800-206-8125. |
GHI and |
Write to: EmblemHealth/GHI Telephone: |
60 business days from receipt of first level |
15 business days from receipt of the request. |
30 business days from receipt of all necessary |
Decision is final. |