Participant Rights

All of us at Pacific PACE share responsibility for your care and your satisfaction with the services you receive. If you do not speak English, a bilingual staff member or translation services will be available to assist you with the process.

Participant Rights and Responsibilities

Please click here for a copy of Pacific PACE’s Bill of Participant Rights and Responsibilities

How to file a grievance

Our grievance procedures are designed to enable you and/or your representative to express any concerns or dissatisfaction you have so that we can address them in a timely and efficient manner. At any time, should you wish to file a grievance, we are available to assist you.

A grievance is defined as a complaint, either written or oral, expressing dissatisfaction with the services provided or the quality of participant care. Please click here for instructions and information about how to file a grievance with Pacific PACE. If you have questions, please contact us at 800-851-0966.

How to file an appeal

Our appeals process is designed to enable you and/or your representative the opportunity to respond to a decision made by the Interdisciplinary Team regarding your request for a service or payment of a service. At any time you wish to file an appeal, we are available to assist you.

An appeal is defined as a participant’s action taken with respect to the PACE organization’s noncoverage of, or nonpayment for, a service, including denials, reductions or termination of services. Please click here for instructions and information about how to file an appeal with Pacific PACE. If you have questions, please contact us at 800-851-0966.

Appointing a Representative

If you would like to appoint a person to file a grievance, request a coverage determination, or request an appeal on your behalf, you and the person accepting the appointment must fill out this form (or a written equivalent) and submit it with the request.

© 2019 Pacific PACE. All rights reserved.

H0934_PacificWeb_CMSApproved_05/21/2019

Page last updated 4/15/2019

© 2019 Pacific PACE. All rights reserved.

H0934_PacificWeb_CMSApproved_05/21/2019

Page last updated 4/15/2019