Member Complaints (Grievances) and Appeals
As a Molina Healthcare member, if you have a problem with your medical care or our services, you have a right to file a complaint (grievance) or appeal. A complaint (grievance) can be filed when you are unhappy with your care. Some examples are:
- The care you get from your provider.
- The time it takes to get an appointment or be seen by a provider.
- The providers you can choose for care.
An appeal can be filed when you do not agree with Molina Healthcare’s decision to:
- Stop, suspend, reduce or deny a service.
- Deny payment for services provided.
We want you to have access to the complaint (grievance) process and can help you through each step.
- File a complaint
- File an expedited appeal
- Appeal a denial
- Request a State Fair Hearing
- Request an Independent Medical Review (IMR)
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