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
For more information, Please call Member Services.
FAX: (562) 499-0610
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 an
expedited grievance whenever Molina Medicare takes an extension relating to an organization
determination reconsideration, or when we refuse to expedite a request for an organization
determination or reconsideration. Molina Medicare will respond to these grievances
with 24 hours after receipt. Our expedited grievance determination will address
only your dissatisfaction with our decision to take an extension or deny your request
to expedite a determination or appeal. The grievance determination will not address
the underlying issue (request for services or payment, etc.) that is the subject
of the organization determination or reconsideration. For after hours, weekend,
or holiday delivery please contact our Nurse Advice Line which is available 24 hours
a day 7 days a week.
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 calendar
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
Click here for the Medicare .
*Printed copies of information posted on our website are available upon request.
You may also access additional information on Medicare's website at www.medicare.gov
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