Let us know of your grievance/complaint. If at any time you are unhappy with Partners or a provider in our network, you can make a grievance/complaint to Partners. We call concerns grievances/complaints.
You can place a grievance/complaint by:
Each option is confidential and secure. You also have the right not to be contacted by us, and not to have your information shared with others involved in the grievance/complaint. However, to serve you better and to effectively resolve the issue, we hope you will let us contact you, if needed.
To learn more about grievances/complaints, contact our Access to Care department 1-888-235-HOPE (4673).
Appeals or Requests for Review
You have the right to appeal if you disagree with our decision to deny, reduce, suspend or terminate a service. An appeal is a request for your review. Your provider and care coordinator can help you file a request by submitting a reconsideration form or by calling the appeals department at 704-884-2650. A reconsideration form is only required if the request is submitted for expedited review. Once your request for a reconsideration review has been made to the appeals department, our case will be reviewed and you will be notified in writing of the new decision.
If you are still unhappy with the decision, you can then request a State Fair Hearing from the North Carolina Office of Administrative Hearings. (Please note–you cannot request an appeal for a service no longer offered in the Partners’ Medicaid Benefit Plan.)
To learn more about appeals, download and read our “Know Your Rights–Appealing a Service Decision” document. If you have specific questions about appeals, call 704-884-2650, Monday through Friday, between 8 a.m. to 5 p.m.
Discrimination is Against the Law
Partners Health Management complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Partners Health Management does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
- Provides free aids and services to people with disabilities to communicate effectively with us, such as:
- Qualified sign language interpreters
- Written information in other formats (large print, audio, accessible electronic formats, other formats)
- Provides free language services to people whose primary language is not English, such as: Qualified interpreters
- Information written in other languages
If you believe that Partners Health Management has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance/complaint with:
- Grievances Coordinator: __________
- Mailing Address: Partners Health Management, C/o Grievances, 901 South New Hope Road, Gastonia, NC 28054
- Phone Number: 1-888-235-HOPE (4673)
- Fax Number: 704-884-2696
- Email: Grievances@partnersbhm.org
If you need these services, call 1-888-235-4673.
You can file a grievance/complaint in person or by mail, fax, or email. If you need help filing a grievance/complaint, you may call 1-877-864-1454, option 3 to speak directly with a member of the grievance/complaint department.
You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, or by mail or phone at:
- U.S. Department of Health and Human Services
- 200 Independence Avenue, SW
- Room 509F, HHH Building
- Washington, D.C. 20201
- 1-800-368-1019, 800-537-7697 (TDD)
Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.