Grievances
If you need help filing a grievance, Empower can help you. Just call 1-866-261-1286 | TTY: 711.
You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights on a computer through the Office for Civil Rights Complaint Portal, at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at:
U.S. Department of Health and Human Services
200 Independence Avenue SW, Room 509F
HHH Building, Washington, DC 20201
1-800–868–1019, 1-800–537–7697 (TDD)
If you wish to mail a grievance, send to:
Empower Healthcare Solutions, LLC
P.O. Box 211446
Eagan, MN 55121
Empower cares about the care and the service we provide. If you are not happy with any part of your care, please call us at 1-866-261-1286 | TTY: 711 or email at ComplaintsAndGrievances@EmpowerArkansas.com and we will call you. Our goal is to help you with your grievance with a single call.
Copies of Complaint forms are at www.hhs.gov/ocr/office/file/index.html.
Appeals
If you do not agree with a decision, you can ask for an appeal. You have 60 days from the date on the letter you receive to file an appeal. To ask for an appeal, you can call us at 1-866-261-1286 | TTY: 711. You can also send a letter to:
Empower Healthcare Solutions
P.O. Box 211446
Eagan, MN 55121
After we receive your appeal, Empower Healthcare Solutions will review within 30 days. We will send a letter with results.
If waiting 30 days for a decision could be a risk, you can ask for a faster decision. This is called an expedited appeal. Empower Healthcare Solutions will decide about expedited appeals in 3 days.
If you need help with making an appeal, we can help. You can reach us by calling 1-866-261-1286 | TTY: 711.
If you ask, Empower Healthcare Solutions must continue to provide you benefits during the appeal process. For that to happen, the following must happen:
- Your request for appeal is timely in accordance with the Code of Federal Regulations (CFR). Timely filing means within sixty (60) calendar days of receiving the denial. It can also be before the effective date of the denied services.
- The PASSE appeal involves the termination, suspension or reduction of previously authorized course of treatment;
- The services were ordered by an authorized provider;
- The period covered by the original authorization has not expired; and
- You timely file for continuation of benefits in accordance with the policy which is ten (10) calendar days from the date of appeal.
You can receive benefits until one of these items occur:
- You withdraw the appeal
- You withdraw the request for benefits
- You do not ask for a fair hearing and you don’t ask to extend benefits within 10 days of Empower sending you a notice that the appeal was not decided in your favor
Please note that if you do not win the appeal, you may have to pay for services received during the appeal process.
Also, you may request a fair hearing and a continuation of benefits if not satisfied with the outcome of your appeal. If you are requesting a continuation of benefits, this request must be made within 10 calendar days after the PASSE sends you the notice of appeal decision If you are not requesting continuation of benefits, you may ask for a fair hearing within ninety (90) calendar days of receipt of resolution of the appeal.