How to file a Complaint (Grievance)

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Members may file a grievance at anytime.

A grievance is an oral or written expression of dissatisfaction, including any complaint, dispute, request for reconsideration, or appeal made by a member.

  • 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) your Molina Healthcare Health Plan.
  • Problems with the member service you received.
  • Problems 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 request for an expedited coverage determination, organization determination, redetermination or reconsideration.
  • You believe our notices and other written materials are difficult to understand.
  • Failure to give you a decision within the required timeframe.
  • Failure to forward your case to the independent review entity if we do not give you a decision within the required timeframe.

If you have one of these types of problems and want to make a complaint, it is called “filing a grievance”. In certain cases, you can ask for an “expedited grievance,” meaning your grievance will be decided no later than 72 hours.

  • Call Molina Healthcare Member Services at (888) 483-0760 or TTY at (800) 346-4128. We will try to solve any complaint (grievance) over the phone.
  • Write a letter and mail it to:
    Molina Healthcare of Utah
    Attn: Complaints and Appeals
    7050 S. Union Park Center, Suite 200
    Midvale, Utah 84047

 

Be sure to include the following:

  • Member’s first and last name
  • Molina Healthcare ID number (It is on the front of your Molina Medicaid Member ID Card.)
  • Member’s address and telephone number
  • Explain the problem