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RESPONSIBiliTY

PROVIDER RELATIONS GRIEVANCE COORDINATOR

OMC SECTION

PROVIDER RELATIONS GRIEVANCE -COORDINATOR

cn:p&p13.3

Policy and Procedure No.: 13.3 Page 4 of 4

ACTION

6.

Forwards Provider Grievance Form (Attachment III) and Grievance Resolution

Form (Attachment V) to appropriate Section, if necessary.

OMC

1

Receives Provider Grievance Form and Grievance Resolution Form.

1

Receives

Grievance Resolution

Form and

"Efovider

Grievance..f;;orm from

OMC Section.

2.

Investigates and/or calls provider for specific information, if required.

Within 20 Calendar Da_~

3. Completes and forwards Grievance Resolution Form and Provider Grievance Form to Provider Relations.

2.

Reviews Grievance Resolution Form for completeness.

Within

30

Calendar

Da vs:

_

1

Prepares and mails Resolution letter

(Attachment

VI)

to

provider.

Attaches

a

copy

of

L.A.

Care's

Grievance

Appeal

Process.

2.

Records resolution code and date of resolution on Informal Complaint and Grievance Log.

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