GRIEVANCEs, APPEALS and fair hearings

You have a voice. Each member of Centennial Care has the right to file a grievance when you are unhappy with your managed care plan or provider. A grievance is sometimes called a complaint. You also have the right to appeal an action taken by your Centennial Care plan. An action is when your Centennial Care Plan denies, delays, limits or stops a service. It is important to read your Centennial Care Member Handbook which explains step-by-step how to exercise these rights. Your member handbook will have Member Services help line phone numbers to get you started. If you file an appeal and do not agree with the decision made by your plan, you can request a Fair Hearing with the state of New Mexico Human Services Department. This step can only happen after completing the appeal process with your Centennial Care Plan.