What is a Grievance?
A grievance is an oral or written expression of dissatisfaction, including any complaint, dispute or request for reconsideration, made by a member.
What types of problems might lead to you filing a grievance?
- Problems with the quality of the medical care you receive, including quality of care during a hospital stay.
- If you feel that you are being encouraged to leave your
(disenroll from) Molina Healthcare health plan.
- Problems with the service you received.
- Problems with how long you have to spend waiting on the phone, in the waiting room, in a pharmacy or in the exam room.
- Disrespectful or rude behavior by providers, nurses, receptionists, pharmacists or other staff.
- Cleanliness or condition of provider offices, clinics, network pharmacies or hospitals.
- You believe our notices and other written materials are difficult to understand.
If you have one of these types of problems and want to make a complaint, it is called “filing a grievance”.
It tells you what you need to know about member grievances and appeals. Read here.