Complaints, grievances, and appeals
Network Health is committed to ensuring quality care and services for its providers and members.
All Network Health providers and members have a right to:
- Voice complaints or grievances about Network Health, the care provided, and those providing care
- File an appeal regarding any adverse decision made by Network Health, including service coverage determination as well as administrative denials
- File an appeal as a member, or as a provider acting on behalf of a member, with the MassHealth Board of Hearings after an adverse action resulting from a final determination (final level of internal Network Health review) related to a medical necessity or service coverage determination
Please refer to our Provider Manual for complete details of our complaints, grievances, and appeals process.