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When you ask for it, the government requires
Molina Healthcare, Inc. to provide you with
reports that describe what happened to formal
complaints that our product, Molina Medicare
received from our Medicare members. There are two
types of formal complaints: Appeals and
Grievances. Medicare members have a right to file
an appeal or grievance with their Medicare health
plans. An appeal is a formal complaint about
Molina Medicare's decision not to pay for, not to
provide, or to stop an item or service that a
Medicare member believes s/he needs.
Each
Medicare health plan will have different numbers
of appeals and quality of care grievances, and
these numbers can mean different things. For
example, a Medicare health plan might have a small
number of appeals and quality of care grievances
because the plan talks with members about their
concerns and agrees to find solutions. You may
contact the plan and ask for a summary report of
the number of grievances and appeals received and
what happened to those complaints over a specific
period of time. |
