For The People We Serve
HealthWest has a Customer Service department dedicated to providing a positive and welcoming experience for anyone who enters our doors. We aim to provide information, resources, and involvement opportunities for individuals we serve, and for our whole community. We invite you to reach out to us with ideas, questions, and concerns.
For client grievances and appeals, please call the Lakeshore Regional Entity (LRE) Customer Service at 855-597-3301.
Grievances and Appeals
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?
When you request services and they are denied or your current services are changed or stopped you will be informed by your staff. (This includes being informed in writing). 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.
You may ask for a “Local Appeal” by contacting the Lakeshore Regional Entity Customer Services Department at 800-897-3301. You or a representative for you will have the opportunity to give information about why the change in your services should not have happened. If that decision is not satisfactory you can appeal by requesting a “Medicaid Fair Hearing” before an administrative law judge. This is a State appeal.
If you have Medicaid; you must ask for a Local Appeal before moving on to a “Medicaid Fair Hearing”. Your appeal will be completed in a timely manner and you will have the chance to provide information or have someone speak for you regarding the appeal. You may ask for assistance from local advocacy organizations to file an appeal.
Staff with the Utilization & Management Department and the Customer Services Department can explain the these steps. They will provide the paperwork you need and help you with filling it out if need be. Staff will give you information so you can check the status of your appeal or complaint.
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
Consumer Satisfaction Survey
Do you or your child receive medical services, adult/youth case management, mental health outpatient services, long-term support services, substance use disorder residential treatment, substance use disorder outpatient services, detox, or methadone services through HealthWest or one of our contracted providers? If so, we want to hear from you!
Please take a minute to fill out a brief survey about your experience.