Grievance & Appeals

Member Grievance and Appeals

As a Molina Healthcare of Nebraska member, if you have a problem with your medical care or Molina's services, You have a right to file a grievance or appeal. A grievance can be filed when you are unhappy with your care. Some examples are:

  • The care you get from your PCP.
  • The time it takes to get an appointment or be seen by your PCP.
  • The providers you can choose for care.
  • You believe our notices and other written materials are difficult to understand.
  • Failure to give you a decision within the required timeframe.

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

  1. Stop, suspend, reduce, or deny a service.
  2. Deny payment for services provided.

If you are not satisfied with the results of your appeal, you may request a State Fair Hearing. A DHHS Hearing Officer will review your case, and you will have the opportunity to present evidence at the hearing. For more information on how to file a grievance, appeal, or State Fair Hearings please click on the links below. We are here to help you! Contact Member Services. 

  1. How to file a grievance
  2. How to file an appeal
  3. Request a State Fair Hearing

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