Customer Service

HealthWest works hard to provide a quick response to concerns and issues from people who receive services, guardians, or community members. If you have a concern or issue you would like to have addressed, please contact the Customer Service Department at 231-720-3201.

There are a couple of ways to seek answers to a concern or complaint that you have; specifically, Grievance and/or an Appeal.  (Local Appeal and A Medicaid Fair Hearing).

What Is a Grievance?
You have the right to say that you are unhappy with your services, support, or the staff who are working with you by filing a “grievance”. You can file a grievance any time by calling Customer Service at 231-720-3201 or The Lakeshore Regional Entity Customer Service Department at 800-897-3301. We can also explain how to get assistance with filing a grievance from local advocacy organizations such as The Arc Muskegon. As a person in services, you will be given detailed information about the grievance and appeal processes when you first start services and then again annually. If you are seeking services and have received a decision about services that you disagree with you may also appeal. Additionally, you may ask your worker for more information or, again, by calling Customer Service at HealthWest or The Lakeshore Regional Entity.

What Is an Appeal?

You will be given notice (adverse benefit determination) when a decision is made that denies your request for services or reduces, suspends or terminates the services you already receive. You have the right to file an “appeal” when you do not agree with such a decision. There are two ways you can appeal these decisions. There are also time limits on when you can file an appeal once you receive a decision about your services. You may ask for an appeal by contacting LRE customer services or your local customer service office.

Your appeal will be completed quickly, and you will have the chance to provide information or have someone speak for you regarding the appeal. You may ask for assistance from Customer Service to file an appeal. A provider or advocate may also ask for an appeal for you.

You have 60 calendar days to file an appeal once you have received the notice that your services were denied, suspended, terminated, or reduced.

If you want to continue to receive your same level of services while your local appeal is pending, you have 10 days to include the request with your appeal.

If you file an appeal, you will receive an acknowledgment letter. You will also receive a disposition (decision) letter in no more than 30 calendar days for standard appeal and 72 hours for an expedited (quick) appeal

If you need assistance completing this form, please contact LRE Customer Services at (800) 897-3301 or customerservice@lsre.org . You may also contact HealthWest Customer Service at 231-720-3201 or customer.services@healthwest.net.

You may contact the Customer Services Department regarding the following:

• Questions about CMH services
• Inquiries about current services
• Concerns about current services
• Information on due process rights including how to file a grievance or appeal