Youth and families may find there are times when they are not satisfied with a decision that is made about the YES services they requested or received. An appeal is a request to change a decision the state has made about your child’s health care. Youth and families cannot be penalized or retaliated against for filing an appeal. This page includes information specific to appeals such as what can be appealed, how and when to file an appeal, frequently asked questions, and more.
Youth and families may also find there are times they wish to file a complaint. To file a complaint or for more information, please see the Concerns/Complaints section of the Contact Us page.
| Appeals Contacts |
Division of Medicaid (Independent Assessor – Liberty, non-emergency medical transportation, EPSDT, inpatient behavioral health services, and other Medicaid benefits)
MedicaidAppeals@dhw.idaho.gov
Phone: 208-334-5747
Fax: 208-364-1811
Mail: Medicaid Appeals – IDHW, PO Box 83720, Boise, ID 83720-0009
In Person: Your Local Health & Welfare Office
Web link for processes: https://publicdocuments.dhw.idaho.gov/WebLink/Browse.aspx?id=17618&dbid=0&repo=PUBLIC-DOCUMENTS
Division of Behavioral Health
Email: APS@dhw.idaho.gov
Mail: 450 West State Street 10th floor P.O. Box 83720, Boise, ID 83720-0036
Fax: (208) 639-5741
An appeal can be requested verbally by calling 855-643-7233 and must be followed up with a written request
using one of the options listed above.
Idaho Behavioral Health Plan – Optum Idaho (Medicaid outpatient behavioral health services)
optumidaho.appeals_grievance@optum.com
Mail: Optum Idaho, 322 E. Front Street, Suite 400, Boise, ID 83702
Fax: 1-855-272-7053
Member Services: 1-855-202-0973
Appeals Process: https://www.optumidaho.com/content/ops-optidaho/idaho/en/members/rights—responsibilities.html
Division of Welfare/Self-Reliance (Eligibility for Medicaid and other benefits)
MyBenefits@dhw.idaho.gov
Phone: 877-456-1233
Fax: 866-434-8278
Mail: Self-Reliance Programs, PO Box 83720, Boise, ID 83720-0026
In Person: Your Local Health & Welfare Office
Web link for processes: https://healthandwelfare.idaho.gov/appeals-and-fair-hearings
Idaho State Department of Education
info@sde.idaho.gov
Mail: Special Education Dispute Resolution Idaho State Dept. of Education P.O. Box 83720 Boise, ID 83720-0027
Phone: (208) 332-6914 or (800) 432-4601
TT: (800) 377-3529
Fax: (208) 334-2228
Dispute Resolution Process: https://www.sde.idaho.gov/sped/dispute/
| Appeals FAQs |
Appeals FAQs coming soon!