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.
- How to file a complaint
- How to file an expedited appeal
- How to appeal a denial
- Request a State Fair Hearing
If you have any problem reading or understanding this or any Molina Healthcare information, call Member Services at (844) 809-8445. We can explain in English or in your primary language. You may request printed versions of these materials and they will be sent to you free of charge and within five business days. We may have it printed in other languages. You may ask for it in braille, large print, or audio. If you are hearing impaired, dial 711 for the Idaho Relay Service.