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How to file a HSN grievance

This page provides information about how to file a grievance with the Health Safety Net.

Health Safety Net

The Details of How to file a HSN grievance

What you need for How to file a HSN grievance

If you are a patient, you may request that the HSN

  • conduct a review of an eligibility determination, or
  • conduct a review of provider compliance with the Health Safety Net regulation.

To file a HSN grievance, send a letter to

Health Safety Net
Attn: HSN Grievances
100 Hancock Street, 6th floor
Quincy, MA 02171

At a minimum, the letter should include your name and address. If possible, it should also include

  • information about the situation
  • the reason for the grievance
  • the provider's name (if a provider is involved), and
  • any other relevant information.

The more information you give, the better. Make sure to include the provider's name if a provider is involved.

You can find more information about this in the Health Safety Net Eligible Services regulation (101 CMR 613.00 in section 613.04(3)). Questions about filing a grievance should be directed to the HSN Help Line at (877) 910-2100.

How to file How to file a HSN grievance

Health Safety Net
Attn: HSN Grievances
100 Hancock Street, 6th floor
Quincy, MA 02171

Contact for How to file a HSN grievance

Address
100 Hancock Street, Quincy, MA 02171
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