As a valuable partner in Molina Healthcare’s provider network, Molina strives to keep open lines of communication, provide important updates. The 2020 MMP Provider Manual Section15 Member Grievances and Appeals has been updated with the following information.

Grievances

Should a Member present a grievance to a provider, the provider must relay the grievance to Molina for proper processing. Please call the Molina Member Service department, Monday through Friday 8:00 a.m. to 8:00 p.m., toll free at (855) 735-5604 or 711 for persons with hearing impairments (TTY/TDD).

Member Consent – Medicaid Covered Service Request

Following Medicaid specific guidelines, any appeal would require written consent from the member for the appeal to be processed, this includes a provider acting on behalf of the member. This also applies to any filed grievance or request for a State fair hearing, on behalf of the member.

What to include with the Appeal

Members should include their name, address, contact information, Member ID number, reason for appealing and any evidence the member wishes to attach. Member’s may send in supporting medical records, documentations, or other information that explains why Molina should provide service.

Click here to read the full announcement sent out by Molina.