Grievance Process

A Grievance is any oral or written expression of dissatisfaction with CeltiCareHealth including medical or Behavioral Health services. Your or your Authorized Representative have the right to file a Grievance if you are not satisfied with any aspect of CeltiCare Health's operations or interactions. You can als file a Grievance if you have a problem with the quality of care or services you receive from a Provider.

A Grievance can also be filed when we:

  • Extend the timeframes to process a Prior Authorization request when you, or your Authorized Representative, disagree with the decision to extend
  • Do not approve your request for an Expedited (fast) Internal Appeal and we process it as a standard Internal Appeal
  • Extend the timeframe to process your Internal Appeal and you, or your Authorized Appeal Representative, disagree with the decision to extend.