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Caring Foundation

Your Rights as a Member

Your Rights   |   You Can File a Complaint or Grievance
You Can Accept or Refuse Treatment   |   Confidentiality and Disclosure of Medical Information

You Can File a Complaint or Grievance

What is the Difference Between a Complaint and a Grievance?

  • You file a complaint when you have questions or concerns related to your benefits or services, provider status, exclusions or other issues related to coverage.
  • You file a grievance when you disagree with the decision of a denial of a health care service that was made by Keystone, based primarily on medical necessity or appropriateness. More information available.

The Complaint Process

Informal Member Complaint Process

The Caring Foundation and Keystone will make every attempt to answer any questions or resolve any concerns you have related to your benefits or services.

If you have a concern:

  • Call the Caring Foundation at 1-800-464-5437; or
  • Write to the Supervisor of Member Services, Caring Foundation, P.O. Box 13449, Philadelphia, PA, 19101-3449.

Most concerns are resolved informally at this stage. If the Caring Foundation cannot immediately resolve your concern, we will investigate it and respond to you within 30 days.

If you are not satisfied with the response to your concern from the Caring Foundation, you have the right to file a formal complaint within 60 days, through the formal member complaint process described below.

Formal Member Complaint Process

You may file a formal complaint regarding an unresolved dispute or objection regarding your coverage, including contract exclusions and non-covered benefits, participating or non-participating health care provider status, or the operations or management policies of Keystone.

The complaint process consists of two internal levels of review by Keystone, and one external level of review by the Pennsylvania Department of Health or the Pennsylvania Insurance Department.

Remember that no legal action can be taken until all of the complaint procedures below have been followed.

Internal First Level Complaint

You may file a formal complaint within 60 days from either your receipt of the original Explanation of Benefits (EOB) or denial letter from Keystone, or from completion of the informal complaint process described above.

To file a first level complaint:

  • Call the Caring Foundation at 1-800-464-5437; or
  • Write to Keystone Member Services, PO Box 8339, Philadelphia, PA 19101-8339.

Keystone’s review of your complaint will be completed within 30 days from the date of receipt of your complaint by Keystone. Keystone will send you a decision in writing no later than five business days after reaching a decision.

If you are not satisfied with the decision on your first level complaint, you may file a second level complaint with Keystone, within 60 days from receipt of the first level decision letter.

Internal Second Level Complaint

To file a second level complaint:

  • Write or call the Member Appeals Unit at P.O. Box 41820, Philadelphia, PA 19101-1820, 1-888-671-5276 or fax 1-888-671-5274 within 60 days from your receipt of the first level decision letter from Keystone.

Keystone will contact you to arrange the second level complaint committee meeting, which will meet and render a decision within 45 days from the date of Keystone’s receipt of your second level complaint.

The second level complaint committee is composed of at least three members who have had no previous involvement with the case. The second level complaint committee members will include Keystone staff, with one-third of the committee being enrollees or other persons who are not employed by Keystone.

You have the right to present your second level complaint to the committee in person, through a representative, or via conference call.

The second level complaint committee meetings are a forum where members are allowed to present their issues in an informal setting that is not open to the public. Two other persons may accompany you unless you receive prior approval from Keystone for additional assistance due to special circumstances. Members of the press may attend only in their personal capacity as a member’s representative. Members may not audio- or video-tape the proceedings.

Keystone will send you a written notice of the decision within five business days of the decision by the second level complaint committee. The decision is final unless you choose to appeal to the Pennsylvania Insurance Department or Department of Health within 15 days after your receipt of the second level decision notice from Keystone.

External Complaint Review

If you wish to appeal the second level complaint decision, you may contact the Pennsylvania Insurance Department or Pennsylvania Department of Health within 15 days after your receipt of the second level decision notice from Keystone, as follows:

Pennsylvania Insurance Department
Bureau of Consumer Services
1321 Strawberry Square
Harrisburg, PA 17120
1-877-881-6388

Bureau of Managed Care
Pennsylvania Department of Health
Attn: Complaint Appeals
P.O. Box 90
Harrisburg, PA 17108-0080
1-888-466-2787

Your complaint appeal should include your name, address, telephone number, the name of Keystone Health Plan East as your managed care plan, your Keystone ID number, and a brief description of the issue being appealed. Also include a copy of your original complaint to Keystone and copies of any correspondence and decision letters from Keystone.

Please note that these procedures may change due to changes in the applicable state and federal laws and regulations.

Member Grievance Process for Decisions Based on Medical Necessity

  • Members may file a grievance of a decision made by Keystone regarding a determination of coverage that was based primarily on medical necessity or appropriateness.
  • The grievance process consists of two internal grievance reviews by Keystone and an external review through an external utilization review agency assigned by the Pennsylvania Department of Health.
  • Remember, no legal action can be taken until all of the grievance procedures have been followed.

Internal First Level Grievance

You, or your provider acting on your behalf, with your written consent, may file a grievance within 60 days of the original Explanation of Benefits (EOB) or denial letter from Keystone, by:

  • Calling as directed in the original notice from Keystone;
  • Calling the Caring Foundation at 1-800-464-5437; or
  • Writing to the Patient Care Management Department, P.O. Box 7890, Philadelphia, PA 19101.

When filing the first level grievance, you (or your provider) must include all necessary supporting information.

The grievance will be forwarded to the first level grievance committee. The first level grievance will be reviewed by one or more persons selected by Keystone who did not previously participate in the decision to deny payment for a health care service and shall include a licensed physician, or, where appropriate, a licensed psychologist, in the same or similar specialty that typically manages or consults on the health care service.

The first level grievance committee will complete its review within 30 days from the date of receipt of your first level grievance request by Keystone. Keystone will then send you and your provider written notice of the decision within five business days of the decision.

The notice will specify the reasons and clinical rationale for the decision and the procedure for appeal. If at that time, you, or your provider on your behalf and with your written consent, wish to appeal the decision of the first level grievance committee, you may appeal to the second level grievance committee within 60 days of receipt of the notice of denial.

Expedited Grievance When a Serious Medical Condition Requires a 48–Hour Review

If your case involves a serious medical condition which you believe would jeopardize your life, health or ability to regain maximum function while awaiting a standard internal first or second level grievance committee review, you, or your provider acting on your behalf and with your written consent, can ask to have your case reviewed by Keystone in a quicker manner. This is called an expedited grievance.

You may request an expedited grievance by:

  • Calling as directed on the original notice from Keystone; or
  • Calling the Caring Foundation at 1-800-464-5437.

Keystone will arrange to have the grievance reviewed by a Keystone medical director who was not involved previously with the case.

This review will be completed promptly, based on your health condition, but in no more than 48 hours after receipt of your grievance request by Keystone.

If you are not satisfied with the expedited decision from Keystone, you may file an internal second level grievance to the second level grievance committee, as described below.

Internal Second Level Grievance

You, or your provider acting on your behalf and with your written consent, may file a second level grievance on your behalf by:

  • Writing or calling the Member Appeals Unit at P.O. Box 41820, Philadelphia, PA 19101-1820, 1-888-671-5276 or fax 1-888-671-5274 within 60 days after your receipt of the first level grievance decision letter from Keystone.

The second level grievance committee, will meet and render a decision promptly, based on your health condition, but no later than 45 days after receipt of your grievance request by Keystone. The second level grievance will be reviewed by three or more persons selected by Keystone who did not participate previously in the decision to deny payment for a health care service. The second level grievance committee shall include a licensed physician, or, where appropriate, a licensed psychologist, in the same or similar specialty that typically manages or consults on the health care or service involved.

If you are appealing to the second level grievance committee, you may designate a representative to participate on your behalf. You have the right to present your second level grievance in person, through a representative, or via conference call.

The second level grievance committee meetings are a forum where members are allowed time to present their issues in an informal setting that is not open to the public. You may be accompanied by a maximum of two other persons unless you receive prior approval from Keystone for additional assistance due to special circumstances. Members of the press may attend only in their personal capacity as a member’s representative. Members may not audio- or video-tape the proceedings.

Keystone will send you and your provider written notice of the decision within five business days after the decision by the second level grievance committee. The decision is final unless you, or your provider acting on your behalf and with your written consent, choose to file an external grievance within 15 days of receipt of the second level decision by Keystone.

External Grievance

If you disagree with the second level grievance committee decision, you may request an external grievance by an independent utilization review agency assigned by the Pennsylvania Department of Health. To request an external grievance:

  • Write to the Patient Care Management Department, P.O. Box 7890, Philadelphia, PA 19101 within 15 days of receipt of the second level decision letter from Keystone.
  • If your health care provider files a grievance on your behalf, Keystone will verify with you that the provider is acting on your behalf, with your consent.
  • You will not be required to pay any of the costs associated with the external review except for a $25 filing fee, payable to Keystone, that should be forwarded to the patient care management department at the above address.

Keystone will contact the Pennsylvania Department of Health to request assignment of a certified utilization review agency to your grievance. Keystone will notify you of the name, address and telephone number of the external agency assigned by the Department of Health to your grievance within two business days of the assignment by the Department.

You, your provider (if authorized to act on your behalf) and Keystone have two business days to notify the Department of Health, if there is an objection to the assignment of the external review agency on the basis of conflict of interest.

The external review agency will send you, your provider (if authorized to act on your behalf) and Keystone a written decision within 60 days of the date when you or your provider filed your request for an external review. Upon receiving the decision from the external review agency, Keystone will authorize payment for services or pay claims if the decision of the external review agency is that the services were medically necessary. The external grievance decision may be appealed to a court of competent jurisdiction within 60 days of the decision by the external agency.

Please note that these procedures may change due to changes in the applicable state and federal laws and regulations.

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