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Home Healthcareplans Cal MediConnect Complaints, Grievances & Appeals

Complaints, Grievances & Appeals

Complaints, Grievances & Appeals

If you have an issue about whether a service is covered, have an issue about the way a service is covered, receive a bill for care, or have a complaint regarding the service you receive from us or one of our providers, please let us know right away. Many problems can be solved by our Customer Service Representatives. If you have a problem, please call SCFHP Customer Service so that we may try to find a solution.

Call:

Toll Free: 1-877-723-4795
TTY/TDD: 1-800-735-2929 or 711
8 a.m. to 8 p.m., Monday through Friday
We have free interpreter services for people who do not speak English.

You have different options for reporting problems and complaints. Select your area of concern for more information on the processes for appeals and how to make a complaint:

  • Medical Care – Concerns about benefits or coverage for medical care (Part C), behavioral health and Long-Term Services and Supports
  • Pharmacy – Concerns about benefits or coverage for drugs (Part D)
  • Quality of Service or Care – Complaints about quality of care, waiting times, customer service, etc.

You can also submit a complaint using the Grievance Form on our website.

For more information on what to do if you have a problem or a complaint, see Chapter 9 in your SCFHP Cal MediConnect Member Handbook.

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