Appeals and grievances in Washington

As a Molina Healthcare member, you have the right to file a complaint (grievance) if you have a problem with your medical care or our services. Some examples are:

• The care you get from your provider
• The time it takes to get an appointment or see a provider
• The providers you can choose for care

An appeal can be filed when you do not agree with our decision to:

• Stop, change, suspend, reduce or deny a service
• Deny payment for services provided

There are many ways to file an appeal or grievance. You can:

• Call Molina Healthcare at (888) 858-3492 (TTY:711), Monday through Friday, 8:00 a.m. to 6:00 p.m., local time. We will try to help you over the phone.
• Log in to the My Molina Member Portal to file online.
• Fill out the Member Grievance Form and submit it by mail, email or fax:
• By mail:

Molina Healthcare

Attn: Grievance and Appeals Unit

PO Box 4004

Bothell, WA 98041

• By email: WAMemberServices@MolinaHealthcare.com

• By fax: (877) 814 0342

We will send you a letter acknowledging receipt of your appeal or grievance within 72 hours. Formal responses are issued within 30 calendar days of receipt for a grievance and 14 days of receipt for an appeal.

For help from the Washington State Office of the Insurance Commissioner (OIC), call (800) 562-6900 or (360) 725-7080, TDD (360) 586-0241, fax (360) 586-0241 or email CAP@oic.wa.gov.

For more information, check your Member Handbook or your Agreement and Evidence of Coverage.

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