Grievance Procedure

At Hometown Health, we place a high value on meeting the needs of our members. To help us continue to provide the benefits and services that you need, we need to hear your concerns as well as your compliments. As a member of Hometown Health, you have the right to submit an Appeal or Grievance.

A grievance is defined as any expression of dissatisfaction about your healthcare experience. When you submit a grievance we will coordinate with the appropriate party to resolve your complaint. An appeal may be submitted if you believe a decision we have made regarding pre-service authorizations or the way way we’ve paid a claim should be reviewed. Hometown Health has established a grievance procedure designed to provide prompt, meaningful and confidential response to your issues.

Please seek immediate assistance from your Primary Care Physician if you have questions or concerns about services or treatment received from providers contracted with Hometown Health.

We will listen to your suggestions carefully and do all that we can to make improvements in our plan. For additional information about your Appeal and Grievance rights and their associated procedures, please refer to your Hometown Health Evidence of Coverage. To view your Evidence of Coverage log into MyChart.