Grievances

<h4>What Is A Grievance?</h4> <p>A grievance is a written complaint or concern about a non-appealable issue regarding a perceived failure by any member of the health care delivery team – including authorized providers, military providers, a TRICARE contractor, or subcontractor personnel – to provide appropriate and timely health care services, access, or quality, or to deliver the proper level of care or service.</p> <p>The grievance process allows you to report in writing any concern or complaint regarding health care quality or service. Any TRICARE civilian or military provider, TRICARE beneficiary, sponsor, parent, guardian, or other representative of an eligible dependent child may file a grievance.</p> <p>As the TRICARE Overseas Program (TOP) Contractor, International SOS is responsible for investigating and resolving all grievances. Grievances are generally resolved within 60 days of receipt. Following resolution, International SOS will notify the party who submitted the grievance that the review has been completed.</p> <p>Grievances may include such issues as:</p> <ul> <li>The quality of health care or services (e.g., accessibility, appropriateness, level of care, continuity, timeliness of care)</li> <li>The demeanor or behavior of providers and their staffs</li> <li>The performance of any part of the health care delivery system</li> <li>Practices related to patient safety</li> </ul> <h4>How Can I File A Grievance?</h4> <p>The following information is required for International SOS to investigate and work toward resolving your emailed grievance:</p> <ul> <li>Contact Information, including: <ul> <li>Beneficiary’s name, address, and telephone number</li> <li>Individual or institutional provider contact details</li> </ul></li> <li>Beneficiary’s date of birth</li> <li>A description of the issue or concern,including: <ul> <li>Date and time of the event</li> <li>Name of the provider(s) and/or person(s) involved</li> <li>Location of the event (address)</li> <li>The nature of the concern or complaint</li> <li>Details describing the event or issue</li> </ul></li> </ul> <p><em>Note:&nbsp;If you are not the involved beneficiary and the beneficiary is age 18 or younger, the adult beneficiary must complete the ‘Authorization to Disclose’ form below, so that International SOS can respond directly to you. If we do not receive an ‘Authorization to Disclose’ form, then International SOS will respond directly to the adult beneficiary.</em></p> <p>{downloaddocs=/providers/tco-media/documents/dd2870:Authorization to Disclose}</p> <p>To file a grievance by email,&nbsp;<a href="mailto:TOPGlobalQualityAssu@internationalsos.com" target="_blank">click here.</a>&nbsp;Grievances can also be mailed to International SOS at the following address, using the attached PDF form:</p> <p>{downloaddocs=/providers/tco-media/documents/grievance-form-and-authorization-to-disclose:Grievance Form}</p> <p>International SOS Government Services, Inc.{nomargin:}</p> <p>Reconsideration/Grievances Department{nomargin:}</p> <p>P.O. Box 11570{nomargin:}</p> <p>Philadelphia, PA 19116 USA</p> <p>{fontweight=500:Note:}<em>&nbsp;To protect your personal information, please ensure when sending this document via email, that you send it as a password protected attachment, with the password sent in a separate email.</em></p> <h4>Additional Information on Grievances</h4> <p>To learn more about grievances, including what to submit and what can be appealed, visit&nbsp;<a href="http://www.tricare.mil/appeals" target="_blank">www.tricare.mil/appeals</a>&nbsp;or&nbsp;<a href="http://www.tricare.mil/grievance" target="_blank">www.tricare.mil/grievance</a></p> <p>If you have any questions about the grievance process, please contact your&nbsp;{contentlink=/contact-us:TOP Regional Call Center}&nbsp;(listen carefully to the prompts for the best option to serve you) or send an email to the TOP Quality Assurance Team at:&nbsp;<a href="mailto:TOPGlobalQualityAssu@internationalsos.com" target="_blank">TOPGlobalQualityAssu@internationalsos.com</a></p>