Your Rights and Responsibilities

As a SelectHealth member, your child or dependent is entitled to a set of rights to make sure he or she is treated fairly. As his or her parent or guardian, you are also accountable to stick to a set of responsibilities to make sure you’re following the rules of your plan.

We do not discriminate in hiring or in supplying healthcare because of existing health issues, color, creed, age, national origin, handicap, religion, sex, or sexual orientation. If you have questions or want to file a complaint or Grievance about a claimed discrimination, please call the SelectHealth Civil Rights Coordinator at 801-442-9950.

Get informed. Review a full list of CHIP member rights and responsibilities.

 

Actions, Appeals, and Grievances

If you have a concern or complaint after a SelectHealth Action, you can file an Appeal or Grievance. Read more about each one to decide which one best meets your needs.

What is an Action?

An Action is when SelectHealth:

  • Denies care or approves less care than you wanted
  • Denies a covered service you have had
  • Lowers the number of services you can get or ends a service we approved 
  • Denies payment for care that you may be responsible to pay for
  • Does not take care of an Appeal or Grievance as soon as we should 

If you have a problem with an Action we have taken, call Member Services. They can solve most problems. If you are unhappy with how things work out with Member Services, you can file an Appeal or Grievance.

What is an Appeal?

An Appeal is when you write and ask us to review an Action we have taken to see if we made the right ruling on your claim. See our Appeal form or contact Member Services at 800-538-5038 for help preparing an Appeal.

You’ll have 90 days from the date we take action to ask for an Appeal. If you need help with an Appeal, call the Appeals department at 844-208-9012. We have interpreters and help for those with hearing problems.

What is a Grievance?

A Grievance is a complaint about anything other than an Action. Some Grievances are:

  • The quality of care you received 
  • A doctor was rude to you 
  • Your rights were not respected by a SelectHealth staff member 
  • A doctor won’t see you in a reasonable amount of time 
  • You were not treated fairly, or you feel you were denied your member rights or discriminated against

See our Grievance form or contact Member Services at 800-538-5038 to file a verbal Grievance.

Learn more about Appeals and Grievances in the CHIP Member Handbook.

 

How to Change Your Plan

Need to change your health plan? Call or see your HPR (Health Program Representative) and ask for the change to be made. If you don’t know who your HPR is, call the CHIP Office at 866-608-9422.

 

CHIP Handbook

Read more about your plan in the CHIP Member Handbook. You’ll find phone numbers, information about programs we offer, details about what is—or isn’t—covered by your plan, and more.

CHIP Handbook – English
CHIP Handbook – Español

Lost your paper copy or need this information in a different format or language? Member Services can help.