Sec. 10.67.09.02-1. Member Complaints — Time Frames for MCOs to Respond to the Department

Latest version.

An MCO shall:

A. Acknowledge an enrollee appeal or grievance reported to it by the Departments complaint resolution unit within 1 business day;

B. Respond to the Departments request for information regarding disputed nonemergency medical care actions within 3 business days;

C. Provide updates in a time frame specified by the Department;

D. Provide medical records within 5 days of the request; and

E. Provide a corrective action plan upon request and within the time frame specified, but not later than 10 days from the date of the request.

                    
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