Customer Service

DWIHN’s Customer Service team is administratively responsible for the oversight and monitoring of the Customer Service mandated functions at DWIHN and Contracted Service Providers.

Customer Service is charged with ensuring that members have choice opportunities, access to services and, are oriented to available benefits and services. We are committed to providing our members and providers with the most accurate and informed benefit, eligibility and claims information in the most effective and efficient manner. 

Customer Service is responsible for prompt assistance in addressing customer complaints and concerns. We value our members’ needs and concerns first and are committed to resolving inquiries promptly. We provide efficient oversight, monitoring and reporting of customer complaints, grievances, and appeals. We value our members’ questions and concerns. Customer satisfaction is key in our efforts to improve quality of care and in “Exceeding Our Customers’ Expectations”.

Staff oversees the Family Subsidy program and the development of Members’ educational materials (i.e. Member Handbook, Provider Directory, Persons Newsletter, and DWIHN’s brochures).

The Customer Service team, through it's Member Engagement initiatives, collaboratively participate with training, educational and outreach events that benefit Members, Providers, and the Community.

What We Provide

Appeals Services

A local appeal is your right to request a review of your service provider’s decision or action to reduce, terminate, suspend or deny services. Your service provider is required to inform you when a decision is made to change or deny services you receive or request. If you do not agree with the decision you may request a local appeal from DWIHN.  An appeal may be initiated as either an oral or written request. Medicaid enrollees and MI Health Link enrollees have sixty (60) calendar days to request a local appeal. Underinsured and uninsured enrollees have thirty (30) calendar days to request a local dispute resolution. In every case, DWIHN customer service appeal staff have thirty (30) calendar days to provide a resolution.

A local appeal or a local dispute resolution request must be filed first with DWIHN before seeking a second decision from a higher authority. For Medicaid and MI Health Link members seeking a second decision on a Medicaid covered service, a State Fair Hearing must be filed within one hundred and twenty days (120) calendar days from the date on the notice of adverse benefit determination. For uninsured or underinsured enrollees, there is a ten (10) calendar day timeframe in which an alternative dispute resolution can be requested.

Your satisfaction is very important to us.  We are here to help you with any problems or questions you might have regarding your behavioral health care services. Just give us a call, we can assist you with:
  • Appeals
  • State Fair Hearing
  • Local Dispute Resolution
  • Alternative Dispute Resolution

Have a question about any enrollee/member appeals, please give us a call at (313) 344-9099 and ask for the Appeals Specialist: Dorian Johnson at ext. 3345.

Family Support Subsidy Program

The Family Support Subsidy Program (FSSP) is a Michigan program to help families who care for their children with severe disabilities at home.  The program can assist with paying for special expenses the family may incur while caring for their child.  The financial support may help prevent or delay placements outside the home.  Supporting families of children with severe disabilities with this program allow families to stay together and gives families flexibility in purchasing special services. 

Families may be eligible for this program if they have a child under age 18 who has been recommended by a local or intermediate school district’s multidisciplinary evaluation team with an eligibility category of:
  • Cognitive impairment (CI)
  • Severe multiple impairments (SXI)
  • Autism spectrum disorder (ASD)
Families in Wayne County may get and turn in applications for the subsidy program at the Detroit Wayne Integrated Health Network by calling (313) 344-9099 between the hours of 8:30am – 5:00pm Monday through Friday.:
  • ext 3212 for Tia Davis
  • ext. 3214 for Dayna Phillips

Grievance Assistance

A grievance is a due process right which allows for an expression of dissatisfaction about any aspect of care or service provided to you by DWIHN and Service Providers with whom we have direct or indirect contracts. You have the right to say you are unhappy with the services and supports you are receiving, the staff providing the services and or the manner services are being rendered. You can file a grievance orally or in writing at any time. If you need help in filing a grievance, our Customer Service Grievance staff is available to help you. Some examples of grievances are:
  • Wait time to get an appointment with or to be seen by your doctor, therapist or case manager;
  • Quality of the care you received
  • Not being treated in a welcoming manner
  • Poor customer service
We take all member complaints seriously and are committed to responding to them in an appropriate and timely manner. You will receive an acknowledgment letter within three (3) to five (5) calendar days of receipt of your grievance. Grievances are investigated and will be resolved within 30 to 90 calendar days. However, you can request an expedited resolution and you have the right to have your grievance resolved as quickly as possible should your condition warrant immediate attention.  DWIHN staff will assist you with these determinations.
 
Should you wish to have someone else to file a grievance on your behalf, you may do so.  However, written authorization is required to have a representative to speak on your behalf.  Therefore, should a grievance be submitted by a representative without written authorization, it will not be processed until receipt of proper documentation.  
Assistance is available in the filing process by contacting:
 
DWIHN Customer Service
707 Milwaukee St.
Detroit, MI 48202
Local: (313) 833-3232
Toll-Free: (888) 490-9698
TTY: (800) 630-1044
8:00am-4:30pm
 
You will be given detailed information about grievances and other due process rights when you initially start services and annually or upon request. You may also ask for this information at any time by contacting the DWIHN Customer Service office.

We Are Here For You

Our Customer Service Representatives will be happy to assist you! Our goal is to provide you with an exceptional “Customer Experience” by providing excellent customer service.

Call 888-490-9698 OR email: pihpcustomerservice@dwihn.org