What is a Grievance?

whatisgrievnc

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”. 

Member Handbook
It tells you what you need to know about member grievances and appeals. Read here.