Filing a Grievance, Local Appeal, or Fair Hearing?

If you receive services from Genesee Health System or one of our contract providers and are not happy with your services, you have the right to request a review.

 

Types of Reviews:

● Grievance    ● Local Appeal    ● Medicaid Fair Hearing 

 

How to File a Grievance

If you are unhappy with your services, you have the right to make a complaint, called a Grievance.

A GHS Customer Services Staff will help you with your grievance.

We will work to resolve the problem as soon as possible.

Ways to file a Grievance:

  1. Call Customer Services at (810) 257-3705 OR Fax: TTY (810) 257-1346
  2. Stop in and See a Customer Services Representative at 1040 W. Bristol Rd, Flint, MI 48507 OR 1402 S. Saginaw St, Flint, MI 48503.
  3. Fill out the Grievance Form and mail, fax, or drop it off at Customer Services. Click HERE to view/download the form.
  4. Fill out the form below.

How to File a Local Appeal

You can file a Local Appeal if:

  • There was a termination, reduction, suspension, or denial of your service that was previously authorized.
  • GHS does not provide authorized services within 14 calendar days of the agreed-upon start date.
  • GHS does not make an authorization or service decision to you within 14 calendar days or 72 hours of an expedited request.
  • GHS does not give you an outcome of your Grievance within 90 calendar days.
  • GHS will not pay for all or some of your services.

Ways to file a Local Appeal:

Contact Region 10 PIHP by calling 1-888-225-4447 and Ask for an Appeal.

How to Request a Medicaid Fair Hearing

After the local appeal has been completed, if the resolution is not in your favor, you will be given information and a form to complete to ask for a Medicaid Fair Hearing. You will have 120 calendar days to make your request. If you have any questions about the hearing process, you may contact the Region 10 PHIP Grievance and Appeal office.

Medicaid Fair Hearing Questions:

Call Region 10 PIHP at 1-888-225-4447

 

You may also have an Office of Recipient Rights (ORR) complaint. For more information, please obtain a copy of the “Your Rights” booklet. Call GHS Recipient Rights at (810) 257-3710 to receive a copy.