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1. What should I expect after filing an appeal?

Merced County Behavioral Health and Recovery Services staff will investigate your appeal and respond to you in writing. You will receive two letters. The first letter will be a notice that we have received your appeal. The State Department of Health Care Services requires that this letter be sent to you within one working day of receipt. The second letter will be sent to you with the results of the investigation. The investigation of your appeal must be responded to within 45 days of receipt.

2. What is the difference between a standard appeal and an expedited appeal?

An expedited appeal must be resolved and notification must be given to the person filing an Appeal in three days after we receive it. An expedited appeal does not have to be in writing. An appeal is considered an expedited appeal when using the standard appeal criteria could jeopardize the consumer’s life, health, or ability to attain, maintain, or regain maximum function. Behavioral Health and Recovery Services staff will determine whether or not your appeal will be considered standard or expedited.

3. What if I do not agree with the results of the investigation?

You have the right to file for a State Fair Hearing before, during, or after the resolution of your appeal. If you do not know how to file for a State Fair Hearing you can contact the Quality Improvement staff at (209) 381-6800 or your Patients' Rights Advocate at (209) 381-6876.

4. What are my rights regarding access to my appeals file?

It is your right to have access to your case file, including medical records, and any other documents and records considered during the appeals process.