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Wyoming Appeals

An appeal is a request you may file when you disagree with a benefit determination including a rescission. You may appeal the decision within 180 days from receipt of the adverse benefit determination. More information on formal appeals can be found on the appeals process can be found in your policy document, Section 10 – Complaints, Grievances and Appeals at:

https://www.mountainhealth.coop/individual-plan-documents-wy

To determine if your request qualifies as an urgent treatment request, please review Section 10 – Complaints, Grievances, and Appeals of your policy document at: 

https://www.mountainhealth.coop/individual-plan-documents-wy

 

If you think Mountain Health Co-op (MHC) has made a wrong decision on a service, supply, or drug you have received, you can contact us in writing or by phone at:

University of Utah Health Plans

Appeals Committee Chairperson, Attn: MHC, 6053 Fashion Square Dr.,

Suite 110, Murray, UT 84107

Telephone: 1-844-262-1560

 

Or you may file a formal request for an appeal here:

https://app.healthcare.utah.edu/uhealthPlans/forms/montanaHealth_appeal

For more information on appeals see Section 10 – Complaints, Grievances and Appeals of your policy document at: https://www.mountainhealth.coop/individual-plan-documents-wy

Appeals

A grievance involves a complaint of unfair treatment or quality of care received from a provider’s staff. A complaint involves a communication from the Covered Person expressing discontent or dissatisfaction with services. You can file a complaint in writing or by phone at:

University of Utah Health Plans

Appeals Committee Chairperson, Attn: MHC, 6053 Fashion Square Dr.,

Suite 110, Murray, UT 84107

Telephone: 1-844-262-1560

 

You may also file a grievance or complaint online at:

https://app.healthcare.utah.edu/uhealthPlans/forms/montanaHealth_complaint

For more information on grievances or complaints see Section 10 – Complaints, Grievances and Appeals of your policy document at: https://www.mountainhealth.coop/individual-plan-documents-wy

Grievance or Complaint

A Claimant (or someone acting on the Claimant’s behalf) may request an independent external review of an adverse benefit determination within 120 days after notice of an adverse benefit determination.  In most cases, before filing an external review, you must first exhaust your internal grievance and appeal rights.

The request shall be made in duplicate and include a fee of fifteen dollars ($15.00) payable by check or money order payable to: The Office of the Wyoming State Treasurer.

  • The fee may be waived for a member whose income is at or below the current federal poverty level guidelines and who files a financial hardship application available upon request from the Wyoming Insurance Department. Request for external review must be made in writing or orally to the University of Utah Health Plans at:

University of Utah Health Plans

Appeals Committee Chairperson, Attn: MHC

6053 Fashion Square Dr.

Suite 110, Murray, UT 84107

Telephone: 1-844-262-1560

 

For more information on external reviews see Section 10 – Complaints, Grievances and Appeals of your policy document at: https://www.mountainhealth.coop/individual-plan-documents-wy

External Review for Health Claim Denials

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Mountain Health CO-OP does not discriminate based on race, color, national origin, disability, age, sex, gender, sexual orientation, or health status in the administration of the plan, including enrollment and benefit determinations.

 

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