Member Grievance (Complaint) 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 grievance (complaint) or appeal. A grievance (complaint) can be filed when you are unhappy with your care. Some examples are:
- You are unhappy with the care you received from your provider.
- You are unhappy with the selection of providers you can choose from 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 grievance (complaint) process and can help you through each step.
- File a Complaint
- Appeal a Denial
- Request an Independent External Review
- Request a State Fair Hearing
HealthChoice Illinois Member Handbook
It tells you what you need to know about member grievances and appeals. Read here.