English translation: dissatisfaction with aspects of service / disagreement with denial of service on medical grounds
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14:57 Jul 20, 2011
English to English translations [PRO] Medical - Medical (general)
English term or phrase:complaint vs. grievance
If you think your issue is really a complaint and should not be treated as a grievance, you may call or write to the Department of Health.
Could you please explain the difference between complaint and grievance so as to enable me to choose exact words?
Explanation: "'When I use a word,' Humpty Dumpty said, in rather a scornful tone, 'it means just what I choose it to mean — neither more nor less.'"
The difference between a complaint and a grievance in ordinary usage is a subtle one, but general usage is no help with this question. In this context, the words mean what the people concerned have decided that they mean.
The people concerned are, I believe, the health authorities of the State of Pennsylvania in the United States. In the UK, as far as I can tell, grievances are employment matters. An employee of the NHS can have a grievance, but not a patient (for official purposes). All the references I have found so far on complaint and grievance procedures for patients come from the US.
It is by no means clear to me that the words are used the same way throughout the US. In many cases they appear to be used as synonyms. However, the specific phrase cited in the question does occur in a document relating to Pennsylvania, and the Department of Health concerned is the Pennsylvania Department of Health:
The difference between a complaint and a grievance is set out in the following document, the Pennsylvania Health Law Project Appeals Brochure 2009:
"A Complaint is a dispute or objection about a participating provider, or about the coverage, operations or management of the plan. Appeals to the MCO about any of the following matters will be considered a Complaint:
• The health plan denies payment for a service a consumer received because the MCO claims a non-MA provider gave the service without its approval.
• The health plan denies a service or payment for a service because it has decided the service is not a covered benefit under the individual’s plan.
• The health plan did not meet the required timeframes for providing the consumer with a service.
• The health plan failed to decide a complaint or grievance a consumer filed within the required timeframes. [...]
A “grievance” is a consumer’s request to have an MCO reconsider a decision solely concerning the medical necessity and appropriateness of the health care service." http://www.phlp.org/wp-content/uploads/2011/03/Appeals-Broch...
This is confirmed by the following, relating to a Pennsylvania Health Care provider called Magellan:
"A complaint is when you tell us you are unhappy with Magellan or your provider or you do not agree with a decision made by Magellan. These are some examples of a complaint:
* You are unhappy with the care you are getting.
* You are unhappy that you cannot get the service you want because it is not a covered service.
* You are unhappy that you have not received services that you have been approved to get. [...]
A grievance is what you file when you do not agree with Magellan’s decision that a service that you or your provider asked for is not medically necessary." http://bucks.pa.networkofcare.org/mh/services/complaint.cfm
-------------------------------------------------- Note added at 8 hrs (2011-07-20 23:13:04 GMT) --------------------------------------------------
Let me repeat: the fact that the source text quoted occurs verbatim in a document from Pennsylvania and nowhere else (at least on the Internet) strongly suggests that the words are being used in the very specific, and frankly arbitrary, senses outlined above. The normal meanings of "complaint" and "grievance" are strictly irrelevant here.
Is this is the context of employment or of patient care? In an employment context, "grievance" has a very specific meaning and not at all the same as "complaint".
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Answers
23 mins confidence: peer agreement (net): +2
Similar but slightly different
Explanation: They're often used interchangeably, but to me, a grievance is usually as a result of feeling that you have been wronged or slighted, usually by one person, whereas a complaint can be more general or more serious.
kmtext Local time: 03:04 Works in field Native speaker of: English, Gaelic PRO pts in category: 24
34 mins confidence:
Complaint = one-off; grievance = general issue
Explanation: I see a complaint as a one off while a grievance is a more general issue.
For example one doctor makes a racist comment - you make a complaint, it's dealt with at one level, one time.
The doctors constantly make racist remarks. The receptionist ignores you or uses a racist word to you. None of the leaflets include a picture of someone of your race - you would raise a grievance. That might go to a higher level of the health service body, etc.
Liz Broomfield United Kingdom Native speaker of: English PRO pts in category: 8
HassanLotfy Egypt Local time: 04:04 Native speaker of: Arabic, English
1 hr confidence: peer agreement (net): +2
dissatisfaction with aspects of service / disagreement with denial of service on medical grounds
Explanation: "'When I use a word,' Humpty Dumpty said, in rather a scornful tone, 'it means just what I choose it to mean — neither more nor less.'"
The difference between a complaint and a grievance in ordinary usage is a subtle one, but general usage is no help with this question. In this context, the words mean what the people concerned have decided that they mean.
The people concerned are, I believe, the health authorities of the State of Pennsylvania in the United States. In the UK, as far as I can tell, grievances are employment matters. An employee of the NHS can have a grievance, but not a patient (for official purposes). All the references I have found so far on complaint and grievance procedures for patients come from the US.
It is by no means clear to me that the words are used the same way throughout the US. In many cases they appear to be used as synonyms. However, the specific phrase cited in the question does occur in a document relating to Pennsylvania, and the Department of Health concerned is the Pennsylvania Department of Health:
The difference between a complaint and a grievance is set out in the following document, the Pennsylvania Health Law Project Appeals Brochure 2009:
"A Complaint is a dispute or objection about a participating provider, or about the coverage, operations or management of the plan. Appeals to the MCO about any of the following matters will be considered a Complaint:
• The health plan denies payment for a service a consumer received because the MCO claims a non-MA provider gave the service without its approval.
• The health plan denies a service or payment for a service because it has decided the service is not a covered benefit under the individual’s plan.
• The health plan did not meet the required timeframes for providing the consumer with a service.
• The health plan failed to decide a complaint or grievance a consumer filed within the required timeframes. [...]
A “grievance” is a consumer’s request to have an MCO reconsider a decision solely concerning the medical necessity and appropriateness of the health care service." http://www.phlp.org/wp-content/uploads/2011/03/Appeals-Broch...
This is confirmed by the following, relating to a Pennsylvania Health Care provider called Magellan:
"A complaint is when you tell us you are unhappy with Magellan or your provider or you do not agree with a decision made by Magellan. These are some examples of a complaint:
* You are unhappy with the care you are getting.
* You are unhappy that you cannot get the service you want because it is not a covered service.
* You are unhappy that you have not received services that you have been approved to get. [...]
A grievance is what you file when you do not agree with Magellan’s decision that a service that you or your provider asked for is not medically necessary." http://bucks.pa.networkofcare.org/mh/services/complaint.cfm
-------------------------------------------------- Note added at 8 hrs (2011-07-20 23:13:04 GMT) --------------------------------------------------
Let me repeat: the fact that the source text quoted occurs verbatim in a document from Pennsylvania and nowhere else (at least on the Internet) strongly suggests that the words are being used in the very specific, and frankly arbitrary, senses outlined above. The normal meanings of "complaint" and "grievance" are strictly irrelevant here.
Charles Davis Local time: 04:04 Native speaker of: English PRO pts in category: 12
The translation workplace 
peer agreement (net): +2
