What is a Grievance?

whatisgrievnc

A grievance (complaint) is an oral or written expression of dissatisfaction made by a member. It can include any complaint, dispute or request for reconsideration.

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.
  • You feel that you are being encouraged to leave (disenroll from) a Molina Healthcare Health Plan.
  • Problems with the service you received.
  • Problems with how long you have to spend waiting on the phone, in the waiting room, in a pharmacy or in the exam room.
  • Disrespectful or rude behavior by providers, nurses, receptionists, pharmacists or other health care staff.
  • Problems with the cleanliness or condition of providers' offices, clinics, network pharmacies, or hospitals.
  • You have difficulty understanding our notices and other written materials.

 

If you have one of these types of problems and want to make a complaint, it is called “filing a grievance."