This section provides an explanation of how members can file a complaint. Hennepin Health wants to assure members that they have all the information to express their dissatisfaction. The following are definitions that will help you understand the meaning of complaints:
APPEALS are complaints that should be made when:
A DENIAL, TERMINATION, REDUCTION (DTR) is a notice you will receive when:
GRIEVANCES are complaints that should be made when:
A STATE APPEAL, also known as a STATE FAIR HEARING is a member’s request for the state to review a decision Hennepin Health made about:
When filing a grievance, appeal or state appeal, you must adhere to the below time lines. If you go over the time allowed, Hennepin Health may not review your grievance or appeal, and the State may not accept your request for a hearing.
To receive assistance with your complaint, you must first document your request. This can be done by either speaking with a Hennepin Health member services representative or filling out and mailing back an appeals and grievances form (PDF). While either option is acceptable, Hennepin Health encourages members to call member services first since that is the fastest way to start the process. One exception to filling out the authorization form is if your physician is appealing on your behalf prior to you receiving services – then you do not need to fill out the authorization form.
Minneapolis Grain Exchange Building
400 South Fourth Street, Suite 201
Minneapolis, MN 55420
To speak with a Hennepin Health member services representative, call 612-596-1036.
If you choose not to file a complaint with Hennepin Health first, you may also contact the Ombudsman for State Managed Health Care Programs to file a complaint or request a state fair hearing. Additionally, members may file a complaint with the Minnesota Department of Health.
Ombudsman for State Managed Health Care Programs
P.O. Box 64249
St. Paul, MN 55164-0249
Phone: 651-431-2660 (Twin Cities metro area); 1-800-657-3729 (toll-free); 1-800-627-3529 (TDD)
Health Policy and Systems Compliance Monitoring Division
Managed Care Systems
P.O. Box 64882
St. Paul, MN 55164-0882
Phone: 651-201-5100 (Twin Cities metro area); 1-800-657-3729 (toll-free)