Medical appeals, determination and grievance processes

How to make a complaint or grievance

If you are very unhappy with Health Share, your health care services or your provider, you can complain or file a grievance. We will try to make things better. Just call Customer Service at 503-416-8090, 1-888-519-3845 or TTY/TDD 711, or send us a letter to the Health Share address on the cover of your member handbook.

We will call or write back immediately and attempt to resolve the issue within five days.  If we are unable to resolve the issue in that timeframe, we will notify you.  We will commit to resolving your issue within 30 days and will send you a letter in 30 days explaining how we will address your complaint.  We will not tell anyone about your complaint unless you ask us to.

Below are links to the forms and information you will need:

Complaint Form

OHP Complaint Form – English

OHP Complaint Form – Spanish

OHP Complaint Form – Russian

OHP Complaint Form – Vietnamese

Your Notice of Hearing Rights

Notice of Hearing Rights – English

Notice of Hearing Rights – Spanish

Notice of Hearing Rights – Russian

Notice of Hearing Rights – Vietnamese

Service Denial and Hearing Request Form

Service Denial Appeal and Hearing Request Form – English

Service Denial Appeal and Hearing Request Form – Spanish

Service Denial Appeal and Hearing Request Form – Russian

Service Denial Appeal and Hearing Request Form – Vietnamese

 

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