Sometimes Partners may decide to deny, suspend, reduce or terminate a request your provider makes for you for State-funded services offered by our plan. You will receive a letter from Partners Tailored Plan notifying you of any decision to deny, suspend, reduce or terminate a service request your provider makes. The letter will include information regarding the reason for the decision and any available options while the appeal is under review.
State-funded services recipients have the right to appeal decisions to deny, suspend, reduce or terminate their services. Partners must receive the appeal in writing within 11 working days from the date of the letter. When you ask for an appeal, Partners has 7 business days to give you an answer. You or your legal guardian can ask for an appeal. You can call Partners at 704-884-2650 or visit our website at partnersbhm.org/grievances-and-appeals if you need help with your appeal request. It’s easy to ask for an appeal by using one of the options below:
EMAIL: Fill out, sign, and email the Appeal Request Form in the notice you receive about our decision. You will find the email listed on the form. We must receive your request no later than 15 working days after the date on the notice.
PHONE: Please call 704-884-2650 to speak with someone in the UM Appeals unit who can help you with filing an appeal. You must request the appeal no later than 15 working days from the date of the notice.
IN PERSON: Fill out, sign, and drop off the Appeal Request Form in person at any of Partners offices during normal business hours. We must receive your request no later than 15 working days after the date of the notice.
Partners will make a decision on your appeal within 7 business days from the day that we get your appeal request. We will mail you a letter to tell you about our decision.
When we decide your appeal, we will send you a letter. If you do not agree with our decision, you can ask for an appeal with the State (DMH/DD/SAS Non-Medicaid Appeals Panel). The request for a state level appeal must be received within 11 calendar days from the date of the letter from Partners.
The State appeals panel (DMH/DD/SAS Non-Medicaid Appeals Panel) will review your request and will issue a decision on your service request. Partners Tailored Plan will make a final decision on your request that is informed by the) decision. We will make a final decision within 10 days of the panel’s decision.
For more information on the Appeals Process, please visit the Appeals section in your Recipient Handbook.