Grievances, Appeals, + Second Opinions
A Grievance, Appeal, and Dispute Resolution form is available by request or download.
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You have the right to say you are unhappy with your services.
How to File a Grievance, Appeal, or State Fair Hearing
Grievances, appeals, and state fair hearings can be filed orally or in writing by contacting LifeWays’ Customer Services.
Simply contact LifeWays and request to file a grievance, start a local appeal, or request a state fair hearing. LifeWays is available to assist you in completing this form.
Explanation of Grievances, Appeals, and State Fair Hearings
You would FILE A GRIEVANCE if you were unhappy with the way your services were provided or how you were treated.
You would FILE AN APPEAL if you were denied services or received a decision that reduced, suspended, or terminated your services.
A STATE FAIR HEARING is an appeal that is presented to a neutral judge for a decision. This can only happen after receiving a local appeal decision.
STEPS TO FILE A GRIEVANCE
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If you are ever unhappy with the way your services are provided, or how you are treated, including network providers, please contact LifeWays and request to FILE A GRIEVANCE. LifeWays will review your grievance and notify you as soon as possible.
You may contact LifeWays at:
Call Customer Service: 1 (800) 630-3690
Stop in and speak with Customer Services
Fill out a Grievance/Appeal + Dispute Resolution form and mail it or drop it off at LifeWays.
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The grievance process may take up to ninety (90) calendar days for a resolution.* But LifeWays’ Customer Services understands this is an important part of your life and we will try to resolve all grievances as quickly as possible.
You have the right to request an expedited of “faster” review if waiting on the standard process seriously jeopardizes your life, health, or your ability to attain, maintain, or regain maximum function.
*Once a grievance is resolved. Customer Services will notify you in writing of the resolution.
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A grievance can be filed at any time.
STEPS TO FILE AN APPEAL
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If you do not agree with a decision made regarding your services, or if a decision is made that denies your request for services or reduces, suspends, or terminates the services you already receive, please contact LifeWays and request to FILE A LOCAL APPEAL. LifeWays will review your appeal and notify you as soon as possible.
You may contact LifeWays at:
Call Customer Service: 1 (800) 630-3690
Stop in and speak with Customer Services
Fill out a Grievance/Appeal + Dispute Resolution form and mail it or drop it off at LifeWays.
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The local appeal process may take up to thirty (30) calendar days for a resolution.
You have the right to request an expedited of “faster” review if waiting on the standard process seriously jeopardizes your life, health, or your ability to attain, maintain, or regain maximum function.
If requested and accepted, you will receive a response to your local appeal within 72-hours.
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Local appeals must be filed withing sixty (60) calendar days from the date of denial notice.
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If you’re unhappy with the resolution of your local appeal, THEN you can contact LifeWays to REQUEST A STATE FAIR HEARING.
You may contact LifeWays at:
Call Customer Service: 1 (800) 630-3690
Stop in and speak with Customer Services
Fill out a Grievance/Appeal + Dispute Resolution form and mail it or drop it off at LifeWays.
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The state fair hearing process may take up to ninety (90) calendar days for a resolution.
You have the right to request an expedited of “faster” review if waiting on the standard process seriously jeopardizes your life, health, or your ability to attain, maintain, or regain maximum function.
To request an expedited hearing, call the Michigan Office of Administrative Hearings and Rules (MOAHR) toll-free at 1 (800) 648-3397.
If requested and accepted, you will receive a response to your local appeal within 72-hours.
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A state fair hearing must be requested withing 120 calendar days from the date of the local appeal decision.
STEPS TO FILE A STATE FAIR HEARING
If you choose to file a grievance or appeal, you are protected by the PATIENT PROTECTION AND AFFORDABLE CARE ACT against retaliation or discrimination.
If you are not receiving the dignity and respect you deserve, or if you are not receiving services according to your plan, it could be that you also want to file an Office of Recipients Rights (ORR) complaint.
The ORR can be reached at (517) 796-4516. Please see the “Know Your Rights” page for more information on the process.