Provider Grievances and Appeals
Sandhills Center has developed a new Provider Grievances and Appeals system that can be utilized by Sandhills Center providers and community stakeholders who wish to submit a complaint/concern about another contracted provider or a Sandhills Center staff member or department.
Additionally, providers who wish to appeal a grievance resolution or adverse action taken by Sandhills Center can submit appeal requests within thirty (30) calendar days of the notification by Sandhills Center. An appeal extension of an additional thirty (30) calendar days can also be granted to Sandhills Center providers if good cause criteria are met. Good cause rationale could include but is not limited to the following:
- Consideration of the voluminous nature of required evidence being gathered to support the appeal request;
- The provider representative or family member is seriously ill which prevents the representative from requesting a reconsideration in person, through another person, or in writing;
- There was a death or serious illness in a party's immediate family;
- Important records were accidentally destroyed or damaged by fire or other causes.
Sandhills Center’s expectation is to resolve all accepted provider grievances and appeals within thirty (30) calendar days of submission.
Do you have questions regarding Provider Grievances and Appeals? Contact the Sandhills Center Provider Help Desk at 1-855-777-4652.
IMPORTANT NOTE: The Sandhills Center Provider Grievance and Appeals system is different than the process for grievances/complaints made by NC Medicaid Members or Recipients of State-Funded services. For more information, go to one of these links or call us:
- NC Medicaid Tailored Plan and NC Medicaid Direct Members' Grievance Information/Form
- State-Funded Services Recipients' Complaint Information/Form
- For additional information or to file a grievance/complaint by phone, call Sandhills Center Member & Recipient Services: 1-800-256-2452 (TTY: 1-866-518-6778)