Grievance and Appeal Documents

Click on the links below for the document you would like:

Appeal and Grievance Division of Responsibilties

Appeal Options for MH & SA

Contacts for Appeal & Grievance

Definitions for Appeal & Grievance

Notice Description Grid

RCA Medicaid Appeal Instruction Form for other appeal options

RCA Medicaid Adequate Notice Template

RCA Medicaid Advance Notice Template

RCA Non-Medicaid Appeal Instruction Form for other appeal options

RCA Non-Medicaid Adequate Notice Template

RCA Non-Medicaid Advance Notice Template

RCA Non-Medicaid Treatment Plan Adequate Notice Template

RCA Treatment Plan Medicaid Adequate Notice Template