An Appeal is a request by a Medi-Cal beneficiary, a beneficiary's representative, or a provider for a review of an "Action" or "Adverse Benefit Determination" taken by SLO Behavioral Health. "Action" and "Adverse Benefit Determination" are the fancy terms used by the State to describe our decision to not give you a service you ask for. We will always mail a written explanation of the action we take, and the notice we send will explain exactly how to file an appeal. The Patients' Rights Advocate is available to help you file the appeal if needed.
SLO Behavioral Health has sixty (60) calendar days after we review your appeal to reach a decision. If you believe that waiting that long will create a serious problem for you, please talk with the PRA about an Expedited Appeal.
If we don't agree with your Appeal, you have a right to file for a State Fair Hearing.