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Grievances and Appeals

What is a Grievance?

A beneficariy's expressed disstistfaction to the Mental Health Plan (MHP), Drug Medi-Cal Organized Delivery System (DMC-ODS), or any provider about any matter having to do with the provision of Medi-Cal services. 

The expressed dissatisfaction is defined as a grievance, whether or not it is submitted in writing, whether or not the beneficiary states that they wish to file a grievance, even if the beneficiary explicitly states they do not want to file a grievance and whether or not the beneficiary uses the term "Grievance."

 

To initiate the Grievance process, or to file an Appeal on an existing Grievance:

Call the QMS Managed Care Support Team at (714) 834-5601 or (866) 308-3074.

Or, you can print and fill out a Grievance or Appeal Form and mail to:

HCA QMS Managed Care Support Team
400 W. Civic Center Dr., 4th Floor
Santa Ana, CA 92701

As an alternative for the Mental Health Plan and Inpatient grievances you may call HCA's Patients' Rights Advocacy Services at (800) 668-4240 or (714) 276-8145.

 

Visit their webpage for brochures, posters, and more information.

 

Grievance or Appeal Form (F346-706) (October 2017)

 

Grievance or Appeal Process Posters - Mental Health Plan

 

Grievance or Appeal Process Posters - Drug Medi-Cal Organized Delivery System