When you feel that there is an issue with your service, you have the right to tell ICS so we can address your specific concerns. ICS has referred to this process as filing a “grievance.” As of March 1, however, ICS is changing the way we refer to grievances, but the process will stay the same.
A member “grievance” is now a “complaint”
The New York State Department of Health (NYSDOH) is now reporting grievances as “complaints.” In order to be in compliance with the state, ICS is also adjusting our language and documentation to reflect this change, and the ICS department that handles these reports will now be called Complaints and Appeals.
Examples of complaints
A complaint refers to any expression of dissatisfaction made by a member or member representative about the operations of providers, insurers or ICS that requires an action by ICS to address and resolve. Examples include the following:
Your transportation came late and made you miss an appointment.
Your home care aide repeatedly treats you disrespectfully.
You could not access a network provider with your wheelchair.
Your care manager does not return your calls.
Who should you report a complaint to?
You can file a complaint with any ICS staff member—your care manager, a rehab technician, a member services coordinator, a nurse, etc. It is important to file it as close to the event that prompted it as possible so that you can be accurate and specific with your details. You can file a complaint in person, in writing or over the phone.
What happens to a complaint?
Most complaints are handled within a few hours or days of their being filed. Issues that are more complicated may take more time, but all have to be resolved within 45 days. If that is too long because it may endanger your health, you may file for an expedited decision.
In any case, if you disagree with a decision ICS makes, you have the right to appeal.