Mrs. Burton is a retiree with substantial income. She is enrolled in an MA-PD plan and was disappointed with the service she received from her primary care physician because she was told she would have to wait five weeks to get an appointment when she was feeling ill. She called you to ask what she could do so she would not have to put up with such poor access to care. What could you tell her? Question 17Select one: a. She could file a grievance with her plan to complain about the lack of timeliness in getting an appointment. b. She must write to the plan and wait for a response and then, if she is still dissatisfied, she could file an appeal with her state Medicaid office requesting transfer to one of its managed care plans. c. She should not expect to get in to see her doctor any more quickly since she is a Medicare patient. d. She should call the doctor’s office to complain since the plan cannot do anything about the doctor’s schedule.
a. She could file a grievance with her plan to complain about the lack of timeliness in getting an appointment.
If Mrs. Burton is dissatisfied with the access to care and the long wait time for an appointment with her primary care physician under her MA-PD plan, she can file a grievance with her plan. A grievance is a formal complaint that she can submit to her plan to express her dissatisfaction and request a resolution to the issue.
By filing a grievance, Mrs. Burton alerts her plan about the problem she encountered with the provider’s timeliness, and the plan will investigate the matter and take appropriate actions to address the issue. It is an essential step for beneficiaries to ensure that their concerns are heard and potentially resolved to improve their overall experience with the plan’s services and healthcare providers.