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Appeals & Grievances

Business Connector

Appeals & Grievances

Softheon Exchange Connector Appeals & Grievances establishes a process for customers to submit their complaints, grievances or appeals regarding eligibility decisions and other activities related to the HIX and health plan.

This process includes the following components:

Being the first point of contact for consumers, employers and assistors (Community Assistors, Navigators, Producers (brokers or agents)) to log their complaints, grievances and appeals
Providing multiple mechanisms to log complaints and grievances
Providing mechanisms to track the life cycle of complaints and grievances and their outcomes
Providing the ability to attach associated documents, voice and video recordings related to the complaints in the system
establishing notification mechanisms to the appellants through multiple channels such as paper, email, text messaging and more
Other complaints, grievances and appeals management features as required

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<p><img src="/HTMLCache/375/exchangeconnector.png" alt="Business Connector" style="border-radius: 20px; float: left;" /></p>
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<h2 style="width: 200px;"><span style="color: #ff3333;">Appeals &amp; Grievances</span></h2>
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<h3><span style="color: #ff3333;">Softheon Exchange Connector Appeals &amp; Grievances establishes a process for customers to submit their complaints, grievances or appeals regarding eligibility decisions and other activities related to the HIX and health plan.</span></h3>
<p></p>
<p><strong>This process includes the following components:</strong></p>
<ul>
<li>Being the first point of contact for consumers, employers and assistors (Community Assistors, Navigators, Producers (brokers or agents)) to log their complaints, grievances and appeals</li>
<li>Providing multiple mechanisms to log complaints and grievances</li>
<li>Providing mechanisms to track the life cycle of complaints and grievances and their outcomes</li>
<li>Providing the ability to attach associated documents, voice and video recordings related to the complaints in the system</li>
<li>establishing notification mechanisms to the appellants through multiple channels such as paper, email, text messaging and more</li>
<li>Other complaints, grievances and appeals management features as required</li>
</ul>
</div>