Member Grievance

Member Grievance Policy

Attachment: Acknowledgement Letter for MHL

Attachment: Acknowledgement Letter_Medicaid

Attachment: Acknowledgement Letter_Non-Medicaid

Attachment: Appeal and Grievance Resolution Processes Technical Requirement

Attachment: Appointment of Representative_MI Health Link

Attachment: Clinical Consultation Request Form

Attachment: Combination Letter_Non-Medicaid

Attachment: DWIHN Extension Notice of Decision_Medicaid

Attachment: DWIHN Extension Notice of Decision_MIHL

Attachment: Enrollee/Member Grievance Timeframes and Procedural Steps

Attachment: Expedited Grievance Notice_MHL

Attachment: Grievance Log_Medicaid & Non-Medicaid

Attachment: Grievance Log_MI Health Link

Attachment: Out of Jurisdiction Letter - MHL

Attachment: Out Of Jurisdiction Letter for Medicaid & Non-Medicaid

Attachment: Request Additional Info from Enrollee for Medicaid and Non-Medicaid

Attachment: Request For Additional Info Enrollee - MIHL

Attachment: Request for Additional Information_Provider Medicaid & Non-Medicaid

Attachment: Request For Additional Information_Provider MIHL

Attachment: Request for Review of Grievance Form-MHL

Attachment: Request for Review of Grievance Medicaid-Healthy Michigan Non-Medicaid

Attachment: Request for Satisfaction Response for Medicaid and Non-Medicaid

Attachment: Request for Satisfaction Response MHL

Attachment: Request for State Fair Hearing

Attachment: Request for State Fair Hearing_Medicaid & Waiver Applicants

Attachment: Resolution Letter for Medicaid

Attachment: Resolution Letter for MHL

Attachment: Resolution Letter for Non-Medicaid

Attachment: Status Letter for Medicaid

Attachment: Status Letter for MHL

Attachment: Status Letter_Non-Medicaid