{"id":26618,"date":"2022-04-26T09:39:51","date_gmt":"2022-04-26T13:39:51","guid":{"rendered":"\/?page_id=22445"},"modified":"2026-09-30T21:27:21","modified_gmt":"2026-10-01T01:27:21","slug":"appeals","status":"publish","type":"page","link":"https:\/\/vayapartners.org\/es\/state-funded\/appeals\/","title":{"rendered":"Recursos de los beneficiarios"},"content":{"rendered":"<div class=\"gb-container gb-container-b3b56ff3\"><div class=\"gb-inside-container\">\n\n<div>\n<p class=\"wp-block-paragraph\">A veces, Vaya Partners puede decidir denegar, suspender, reducir o terminar una solicitud que su proveedor le haga para servicios financiados por el Estado incluidos en nuestro plan. Recibir\u00e1 una carta de Vaya Partners inform\u00e1ndole sobre cualquier decisi\u00f3n de denegar, suspender, reducir o terminar una solicitud de servicio realizada por su proveedor. La carta incluir\u00e1 informaci\u00f3n sobre el motivo de la decisi\u00f3n y cualquier opci\u00f3n disponible mientras se est\u00e9 evaluando la apelaci\u00f3n.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Los beneficiarios de servicios financiados por el Estado tienen derecho a apelar las decisiones que deneguen, suspendan, reduzcan o terminen sus servicios. Vaya Partners debe recibir su apelaci\u00f3n por escrito dentro de los 15 d\u00edas h\u00e1biles siguientes a la fecha de la carta de notificaci\u00f3n.<\/p>\n<\/div>\n\n\n\n<div>\n<h2 class=\"gb-text\">\u00bfQu\u00e9 puedo esperar durante el proceso de apelaci\u00f3n?<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Cuando solicite una apelaci\u00f3n, Vaya Partners tiene siete d\u00edas h\u00e1biles para responderle. Puede pedir a un familiar, un amigo, a su proveedor o a un representante legal que le ayude con su apelaci\u00f3n. Usted o su tutor legal pueden solicitar una apelaci\u00f3n. Puede llamar a los Servicios para Miembros de ACCESS en <a href=\"tel:1-888-235-4673\" target=\"_blank\" rel=\"noopener\" title=\"\">1-888-235-4673<\/a> si necesita ayuda con su solicitud de recurso.<\/p>\n<\/div>\n\n\n<div class=\"gb-container gb-container-255d2d90\"><div class=\"gb-inside-container\">\n\n<h2 class=\"gb-text\">\u00bfC\u00f3mo puedo presentar un recurso?<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Es f\u00e1cil solicitar un recurso utilizando una de las opciones siguientes:<\/p>\n\n\n\n<p class=\"icon-mail wp-block-paragraph\"><strong>CORREO:<\/strong>&nbsp;Rellene y firme el formulario de solicitud de recurso que figura en la notificaci\u00f3n que reciba sobre nuestra decisi\u00f3n. Env\u00edelo por correo, junto con cualquier informaci\u00f3n adicional que desee que tengamos en cuenta, a la direcci\u00f3n que figura en el formulario. Debemos recibir su formulario a m\u00e1s tardar 15 d\u00edas h\u00e1biles despu\u00e9s de la fecha que figura en la carta de notificaci\u00f3n.<\/p>\n\n\n\n<p class=\"icon-fax wp-block-paragraph\"><strong>FAX:<\/strong>&nbsp;Rellene y firme el formulario de solicitud de recurso que figura en la notificaci\u00f3n que recibe sobre nuestra decisi\u00f3n. Env\u00edelo por fax, junto con cualquier informaci\u00f3n adicional que desee que tengamos en cuenta, al n\u00famero que figura en el formulario. Debemos recibir su formulario a m\u00e1s tardar 15 d\u00edas h\u00e1biles despu\u00e9s de la fecha que figura en la carta de notificaci\u00f3n.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Correo electr\u00f3nico:<\/strong> Rellene y firme el formulario de solicitud de recurso que encontrar\u00e1 en la notificaci\u00f3n que reciba sobre nuestra decisi\u00f3n. Env\u00edelo por correo electr\u00f3nico, junto con cualquier informaci\u00f3n adicional que desee que tengamos en cuenta, a la direcci\u00f3n que figura en el formulario. Debemos recibir su formulario a m\u00e1s tardar 15 d\u00edas h\u00e1biles despu\u00e9s de la fecha que figura en la carta de notificaci\u00f3n.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>ONLINE:<\/strong> Presente el Formulario de Solicitud de Apelaci\u00f3n disponible en los Vaya Partners <a href=\"https:\/\/vayapartners.org\/es\/member-recipient-portal\/\">Portal de MemberCONNECT<\/a>. Adjunte los documentos que desee que tengamos en cuenta.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>TEL\u00c9FONO:<\/strong> Llame a los Servicios de Miembros de ACCESS en&nbsp;<a href=\"tel:%201-888-235-4673\">1-888-235-4673<\/a>&nbsp;y pedir una apelaci\u00f3n.<\/p>\n\n\n\n<p class=\"icon-email wp-block-paragraph\"><strong>EN PERSONA:<\/strong>&nbsp;Puede entregar personalmente la apelaci\u00f3n en la oficina de Vaya Partners en la direcci\u00f3n 901 S. New Hope Road, Gastonia, NC 28054.<\/p>\n\n<\/div><\/div>\n\n\n<div>\n<h2 class=\"gb-text\">Plazos para las decisiones de recurso<\/h2>\n\n\n\n<div>\n<h3 class=\"gb-text\">Plazos para los recursos<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Vaya Partners tomar\u00e1 una decisi\u00f3n sobre su apelaci\u00f3n en un plazo de siete d\u00edas laborables a partir del d\u00eda en que recibamos su solicitud de apelaci\u00f3n. Le enviaremos una carta para informarle de nuestra decisi\u00f3n.<\/p>\n<\/div>\n\n\n\n<div>\n<h3 class=\"gb-text\">Decisiones sobre recursos<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Si no est\u00e1 de acuerdo con nuestra decisi\u00f3n, puede solicitar una apelaci\u00f3n ante el Panel Estatal de Apelaciones No-Medicaid. El panel forma parte de la Divisi\u00f3n de Servicios de Salud Mental, Discapacidades del Desarrollo y Uso de Sustancias del Departamento de Salud y Servicios Humanos de Carolina del Norte (NCDHHS).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Su carta de decisi\u00f3n de Vaya Partners incluir\u00e1 un formulario de solicitud de apelaci\u00f3n estatal no relacionada con Medicaid. Para solicitar una apelaci\u00f3n ante el Panel estatal de apelaciones no relacionadas con Medicaid, env\u00ede por correo o fax el formulario cumplimentado a:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>CORREO:<\/strong> Divisi\u00f3n de la Oficina de Audiencias del MHDDSUS, c\/o Customer Service and Community Rights, Mail Service Center 3001, Raleigh, NC 27699-3009<\/li>\n\n\n\n<li><strong>FAX:<\/strong> 984-777-9264<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">La solicitud de apelaci\u00f3n a nivel de NCDHHS debe ser recibida dentro de los 11 d\u00edas naturales siguientes a la fecha indicada en la carta de Vaya Partners.<\/p>\n<\/div>\n\n\n\n<div>\n<h3 class=\"gb-text\">Panel estatal de apelaciones no relacionadas con Medicaid<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">El Panel Estatal de Apelaciones no relacionadas con Medicaid revisar\u00e1 su solicitud y emitir\u00e1 sus conclusiones y decisiones recomendadas. Vaya Partners emitir\u00e1 una decisi\u00f3n final por escrito sobre su solicitud en la que se tendr\u00e1n en cuenta las conclusiones del Panel de Apelaciones Estatal No Medicaid. Tomaremos una decisi\u00f3n definitiva en un plazo de 10 d\u00edas a partir de la recepci\u00f3n de las conclusiones del panel.<\/p>\n<\/div>\n<\/div>\n\n\n\n<div>\n<h2 class=\"gb-headline gb-headline-50095724 gb-headline-text\">Continuaci\u00f3n de los servicios durante un recurso<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">A veces, la decisi\u00f3n de Vaya Partners reduce o interrumpe un servicio sanitario que usted ya est\u00e1 recibiendo. Puede pedir que se mantenga este servicio sin cambios hasta que finalice su apelaci\u00f3n.<strong> Vaya Partners no est\u00e1 obligado a continuar este servicio.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Para solicitar que se contin\u00faen los servicios durante su apelaci\u00f3n, llame al Equipo de Apelaciones de Miembros de Vaya Partners en <a href=\"tel:1-800-893-6246\" target=\"_blank\" rel=\"noopener\" title=\"\">1-800-893-6246<\/a>ext. 1400.<\/p>\n<\/div>\n\n<\/div><\/div>","protected":false},"excerpt":{"rendered":"<p>Sometimes Vaya Partners may decide to deny, suspend, reduce, or terminate a request your provider makes for you for State-funded services covered by our plan. 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