Are you having problems with your medical care or our services? If so, you have a right to file a grievance or appeal.

A grievance can be for anything you are dissatisfied about, like:

• The care you get from your provider
• The time it takes to get an appointment or be seen by a provider
• Provider availability in your area

An appeal can be filed when you do not agree with Molina Healthcare’s decision to:

• Stop, suspend, reduce or deny a service you are already receiving

You may also ask for a State Hearing.

View and print the Member Grievance Form in English.

For more information, click on the links below:

How to file a grievance
How to appeal a denial
How to file a state hearing

How to file a Grievance

You can file a grievance in several ways.

To file a grievance with Member Service you can:

• Call the Member Services Department at 1-800-642-4168 (CFC) or TTY/Ohio Relay Service 1-800-750-0750.  We try to resolve your grievance while on the phone.
• Fill out the Grievance/Appeal form. View and print the Member Grievance Form.  It is also in your Member Handbook.
• Write a letter.  Be sure to include:
  -Your first and last name
  -Your Molina ID number on the front of your member ID card
  -Your address and telephone number
  -An explanation of the problem

Mail the form or your letter to:

Molina Healthcare of Ohio, Inc.
P.O. Box 349020
Columbus, OH 43234-9020

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How to appeal a denial

Molina Healthcare will send you a letter if we make a decision to:

• Deny a request to cover a service for you
• Reduce, suspend or stop care you are already receiving
• Deny payment for a service you received that is not covered by Molina Healthcare

This letter will tell you about your right to appeal. You can read about these rights in your Member Handbook.

Member Services also can help you file an appeal.

How to File a State Hearing

You have the right to ask for a state hearing. You can do this at anytime during an appeal. Someone can call for you. It can be someone you say can act for you. It can also be a provider acting for you. You must write a note that gives permission for someone to act on your behalf.

If you want to file a state hearing, you must request this hearing within (90) calendar days from the mailing date on the state hearing form that Molina Healthcare sends to you. Call Member Services or see your Member Handbook for more information about your right to a state hearing.

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*Printed copies of information posted on our website are available upon request.

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