MEMBER HANDBOOK - Community Care Behavioral Health

41
You will receive a decision letter within 60 days of the date you asked
for an External Grievance Review. This letter will tell you the reason(s)
for the decision and what you can do if you do not agree with the
decision.
What should I do to continue getting services if Community
Care was authorizing services, but decided that those services
should now be reduced, changed, or stopped because they are
not medically necessary for me?
If you file:
A First Level Grievance within 10 days of the date on the
letter from Community Care telling you of this decision...
A Second Level Grievance within 10 days of the date
on the letter from Community Care telling you of this
decision...
An External Grievance within 10 days of the date on the
letter from Community Care telling you of this decision...
You will
continue to
receive those
services until
a decision
is made
about your
grievance.
If you have any questions about complaints or grievances, call:
• Community Care's toll-free number, 1-800-553-7499
• Pennsylvania Legal Aid Network (www.palegalaid.net),
1-800-322-7572
• Pennsylvania Health Law Project (www.phlp.org), 1-800-274-3258
• Your local legal aid office.
Customer Services 1-800-553-7499