An appeal is a request you may file when you disagree with a benefit determination including a rescission. You may appeal the decision within 180 days from receipt of the adverse benefit determination.Â
To determine if your request qualifies as an urgent treatment request review Section 10 – Complaints, Grievances, and Appeals of your policy document.
Find your policy in your member portal.
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Contact customer service 800-299-6080
A grievance involves a complaint of unfair treatment or quality of care received from a provider’s staff. A complaint involves a communication from the Covered Person expressing discontent or dissatisfaction with services.
If you think Mountain Health Co-Op has made a wrong decision on a service, supply, or drug you have received, you can contact us in writing or by phone at:
Mountain Health Co-Op
PO Box 5358
Helena, MT 59604
A Claimant (or someone acting on the Claimant’s behalf) may request an independent external review of an adverse benefit determination within 120 days after notice of an adverse benefit determination. In most cases, before filing an external review, you must first exhaust your internal grievance and appeal rights.Â
