What is a Grievance?
A grievance is an oral or written expression of dissatisfaction with any aspect of the MCP’s or provider’s operation, provision of health care services, activities, or behaviors, other than an MCP’s action.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 (dis-enroll from) Molina Healthcare Health Plan. Your provider should not encourage you to join one health plan over another.
- Dissatisfaction with the member service you received.
- Unhappy with how long you have to spend waiting on the phone, in the waiting room, in a network pharmacy or in the exam room.
- Problems with getting appointments when you need them or having to wait a long time for an appointment.
- Disrespectful or rude behavior by doctors, nurses, receptionists, network pharmacists or other staff.
- Cleanliness or condition of doctor’s offices, clinics, network pharmacies or hospitals.
- If you disagree with our decision not to expedite your appeal request you believe our notices and other written materials are difficult to understand.
- Failure to give you a decision within the required timeframe.