www.MercyCareAZ.org

August 29, 2022

Grievances for Specialty Transportation Providers



Applicable to: Mercy Care Complete, Mercy Care RBHA, Mercy Care Long Term Care, Mercy Care DD and Mercy Care DCS CHP

                           

Mercy Care would like to outline our expectations for transportation providers during and following the grievance investigation process.  


Mercy Care is committed to placing our members at the heart of everything we do.  In order to best serve our members, Mercy Care requires the cooperation of our transportation providers during the grievance process. Transportation providers are contractually obligated to participate and cooperate in any grievance investigation that arises from the dissatisfaction of one of our members. 


The following steps outlines the precise expectations that Mercy Care has for its transportation providers with respect to the grievance process. Upon receipt of any complaint:

  1. Transportation providers are required to read the complaint and make note of the analyst’s due date. 
  2. On the infrequent occasion that there might be barriers to meeting a complaint deadline, providers may request an extension by emailing the analyst with their reason for the request and the date by which they expect to have a response. However, extension requests must be made prior to the original complaint due date.  
  3. When responding to a grievance, transportation providers need to carefully review every part of the complaint and provide a response to every question, even when providers may not understand the relevance. It is important that providers cooperate fully with the investigative process.
  4. Provider responses should be detailed and thorough with the objective of resolving the complaint timely by preventing the need for additional follow up questions.
  5. Providers must clearly communicate in their responses which question they are answering either by restating the question prior to providing the answer or by copying the questions into the response and responding directly to each one.
  6. Providers are required to note accurate dates and times associated with the aggrieved trip, even if the grievance is unrelated to the date and time of the trip.
  7. In the event that during the investigative process, a provider is found to have acted in error, providers are required, as part of their response, to provide a reasonable plan of action that addresses and/or prevents recurring offenses.

 

Should a provider fail to follow the steps above as they are outlined, the result will be as follows:

  • If a provider does not respond to a grievance by the original due date and has not requested an extension, then a second request for the response will be sent on the grievance due date.
  • Providers receiving a second request will be given one (1) additional day to provide Mercy Care with a response in order to avoid further corrective action by the health plan.


Mercy Care appreciates the hard work of our service providers and looks forward to their continued cooperation during the grievance process.

 

Please don't hesitate to contact your Mercy Care Network Management Representative with any questions or comments. You can find this Notice and all other provider notices on our Mercy Care website.


Thanks for all you do!


                           
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