KernBHRS is dedicated to providing high-quality mental health and/or substance use treatment possible for our clients. If you are dissatisfied with any aspect of your care or services, you have the right to file a grievance or appeal. A Patients’ Rights Advocate is available to explain the grievance and appeal process and answer any questions you may have at (844) 360-8250.

Beneficiary Grievance and Appeal Rights

• To be treated with dignity and respect. 
• To file a Grievance or Appeal verbally or in writing in the primary or preferred language.
• To ask for assistance with the Grievance and Appeal process.
• To authorize another person to act on his/her behalf
• To identify a staff person or other individual to assist with the Grievance or Appeal process
• To identify a staff person or other individual to provide information regarding Grievance process status.
• To not be subject to discrimination or any other penalty for filing a Grievance or Appeal. 

• To continue receiving services while an Appeal is pending. 

What is a Grievance

A grievance is an expression of dissatisfaction regarding any matter related to your services that is not an Adverse Benefit Determination.  

Grievance Filing Rights

Grievance Timeframes

You will receive written acknowledgment of your grievance within 5 calendar days of receipt. 

KernBHRS will resolve your grievance within 30 calendar days of receipt 

What is an Appeal? 

An appeal is a request for review of an Adverse Benefit Determination. 

An “Adverse Benefit Determination” includes, but is not limited to: 

• Denial, or limited authorization of a requested service, including the type of level or service, medical necessity, appropriateness, setting, or effectiveness of a covered benefit;
• Reduction, suspension, or termination of a previously authorized service; 
• Denial, in whole or in part, of payment for a service; 
• Failure to provide services in a timely manner, as determined by Plan; 
• Failure to act within required timeframes for standard resolution of grievances and appeals; or 
• Denial of a beneficiary’s request to dispute financial liability. 

Appeal Filing Rights

You may file an appeal within 60 calendar days from the date of the Notice of Adverse Benefit Determination.  

An appeal may be filed orally or in writing. 

An appeal may be submitted by:  

• The beneficiary; 
• A provider; or 
• An authorized representative acting on behalf of the beneficiary.

If an authorized representative or provider files a grievance on your behalf, documentation authorizing representation may be required. 

Appeal Timeframes

You will receive written acknowledgement of your appeal within 5 calendar days of receipt.  

Standard appeals will be resolved within 30 calendar days of receipt. 

You may request an expedited appeal if the beneficiary or the beneficiary’s provider certifies that waiting for a standard appeal resolution could seriously jeopardize your life, physical health, mental health or substance use disorder condition and/or ability to attain, maintain, or regain maximum function.  

Expedited appeals will be resolved no later than 72 hours from the date and time of the expedited appeal receipt. 

State Fair Hearing Rights

You have the right to request a State Fair Hearing if: 

A request for a State Fair Hearing must be submitted within 120 calendar days from the date of the Notice of Appeal Resolution. 

Please note: The County’s Grievance & Appeal System must be exhausted, prior to the requesting of a State Fair Hearing. It is intended to resolve problems in the most prompt, efficient and effective manner possible. 

What We Need to Know 

When you ask for help, we’ll reach out to learn what happened. Please be prepared to share: 

• Your name, phone number and mailing address 
• Description of complaint 
•  Date of the incident 
•  Names of people involved, include the treatment provider name and any involved staff 
•  Have you talked with your case manager, therapist or the supervisor? 
•  What do you want to happen next? 

How to File a Grievance or Appeal

Complete a grievance or appeal form and mail to:

Kern Behavioral Health & Recovery Services 
Office of Patients’ Rights
P.O. Box 1000
Bakersfield, CA 93302

Contact the Office of Patients’ Rights directly at 844-360-8250.

Ask to speak to the supervisor at your clinic location or "Fee-for-Service" Provider site.

Forms are available below and at all KernBHRS and contract provider locations.