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Members

Filing a Complaint / Grievance with Molina Dual Options

If you have a complaint, we encourage you to first call Member Services. We will try to resolve any complaint that you might have over the phone. If you request a written response to your phone complaint, we will respond in writing to you. If we cannot resolve your complaint over the phone, we have a formal procedure to review your complaints. We call this our Member Grievance Process.

You must file your grievance within 60 days of the event that gives rise to the grievance. You may file a grievance either orally or in writing, by one of the methods below.

Contact Member Services

E-mail: You can submit your requests online at Medicare.AppealsandGrievances@MolinaHealthcare.com

FAX: (562) 499-0610

WRITE: Molina Healthcare
Attn: Grievance and Appeals
P.O. Box 22816
Long Beach, CA 90801-9977

We will respond to all written grievances in writing. We will respond to oral grievances orally, unless you specifically request a written response. We will respond to all quality of care grievances in writing, regardless of how the grievance was filed.

Expedited Grievance Procedure:

You (or your representative, with appropriate authorization) are entitled to a fast complaint. The legal term for “fast complaint” is “expedited grievance.”

  • If you are making a complaint because we denied your request for a “fast coverage decision” or a “fast appeal,” we will automatically give you a “fast complaint” and respond to your complaint within 24 hours.
  • If you are making a complaint because we took extra time to make a coverage decision or appeal, we will automatically give you a “fast complaint” and respond to your complaint within 24 hours.

If possible, we will answer you right away. If you call us with a complaint, we may be able to give you an answer on the same phone call. If your health condition requires us to answer quickly, we will do that.

Standard Grievance Procedure:

For all other grievances, we will make a decision and notify you of our decision as your case requires based on your health status, but not later than 30 business days after receiving your complaint. We may extend the timeframe by up to 14 calendar days if you request the extension, or if we justify a need for additional information and the delay is in your best interest.

Medicare.gov Complaint Form

To submit a Medicare Complaint Form online, click here.
You may also access additional information on Medicare's website at http://medicare.gov/claims-and-appeals/file-a-complaint/complaint.html

 

 

*Printed copies of information posted on our website are available upon request. 

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