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Speak another
language?
¿Habla otro idioma?
Let us interpret
We can help you no matter what your
preferred language is. We have a free
interpretation service. Just call us at
1-800-782-0095
during office hours.
Ask for translation services in the
language you prefer. You also can call
MedCall after hours at
1-888-850-1108
.
You can ask for written materials about
your benefits to be read to you over the
phone in your language. Or you can get
them in writing in that language. Just call
the number above. If you have hearing
or speech loss, you can call the TTY line
at
1-866-368-1634
.
Podemos traducir esto gratuitamente.
Llame al número de servicio de atención
al cliente que aparece en su tarjeta de
identificación (ID card).
A State Fair Hearing is a chance for you to go to
the state to help resolve an issue if you have already
gone through the complaint process and:
•
We have denied, delayed or changed a service,
and you are not happy with the outcome.
•
We have not given you timely service.
It’s a meeting with you (and
anyone you choose to have
with you), a State Hearings
Officer, a representative
from the Department
of Health and Human
Resources (DHHR),
and a witness.
If we have denied,
delayed or changed a
service, you will get a
letter from us (called
a Notice of Action
letter). You have
90 calendar days
What is Quality
Improvement?
Did you know we check the quality of
services that members such as you
receive? We call this Quality Improvement.
If you would like to know how we use that
information to help improve the quality
of our benefits and services, or if you just
want to learn more about the program,
visit
UniCare.com
.
❯
Under
OTHER UNICARE WEBSITES
:
select
Medicaid
.
❯
Enter a site:
West Virginia
and click
Enter
.
❯
Scroll down to
Quality
Improvement Overview
.
You can also call
1-800-782-0095
for a paper copy.
What is a State Fair Hearing?
And when could you ask for one?
from the date of the Notice of Action to ask for a
State Fair Hearing.
How to ask for a State Fair Hearing
You can ask for a State Fair Hearing by calling
your local DHHR office. The number is in your
local phone directory. You can also request a State
Fair Hearing in writing by filling out a Request
for Hearing form. Information on how to do this
comes with your Notice of Action letter.
When you request a State Fair Hearing, someone
from UniCare also will contact you to try and
resolve the issue before the hearing. If you are
happy with the result, you will need to call the
DHHR and stop your request for a State Fair
Hearing. If you ask for a State Fair Hearing, you
will get a letter from the State Hearings Officer that
tells you the date and time of the hearing. The letter
also will tell you what you need to know to get ready
for the hearing. The hearing can be held by phone.
What to do at the State Fair Hearing
You can explain why you asked for this hearing. You
can also ask the State Hearings Officer to check the
information you sent in and make a decision.
The DHHR will give you a final decision in writing
within 90 calendar days from the date you asked
for the hearing.
You may keep your benefits while your State Fair
Hearing is going on if you submit your request
within 10 days of when we mail you the Notice of
Action letter or the date of the planned action. You
may have to pay for services you received while
you were waiting for an answer if the final decision
does not give you the answer that you asked for.
What you can do if you disagree
with the decision
If you still have a problem with the State Fair
Hearing decision, you can take your case to Circuit
Court within 120 calendar days of the date of your
notice of the State Fair Hearing decision.
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•
My Health