Appeals and Grievances
If you are dissatisfied with the services, system, or clinical care provided by MHN or its network providers, please file a complaint online form; contact MHN at the number listed on your ID card or call (888) 327-0010; or complete this printable form and mail it to: MHN Appeals and Grievances, P.O. Box 10697, San Rafael, CA 94912.
If you wish to appeal a decision MHN made to deny authorization or payment for treatment or services, you may request an appeal using the online form; by calling the MHN Member Appeals information line at (888) 426-0028; or by sending your request and all pertinent supporting information to: MHN Appeals and Grievances, P.O. Box 10697, San Rafael, CA 94912.
If you are a California resident, the process is governed by law, and you have the option of filing an appeal or making a complaint online in Spanish or Chinese:
The California Department of Managed Health Care is responsible for regulating health care service plans. If you have a grievance against your health plan, you should first telephone your health plan at (888) 426-0028 and use your health plan's grievance process before contacting the department. Utilizing this grievance procedure does not prohibit any potential legal rights or remedies that may be available to you. If you need help with a grievance involving an emergency, a grievance that has not been satisfactorily resolved by your health plan, or a grievance that has remained unresolved for more than 30 days, you may call the department for assistance. You may also be eligible for an Independent Medical Review (IMR). If you are eligible for IMR, the IMR process will provide an impartial review of medical decisions made by a health plan related to the medical necessity of a proposed service or treatment, coverage decisions for treatments that are experimental or investigational in nature and payment disputes for emergency or urgent medical services. The department also has a toll-free telephone number (1-888-HMO-2219) and a TDD line (1-877-688-9891) for the hearing and speech impaired. The department's Internet Web site http://www.hmohelp.ca.gov has complaint forms, IMR application forms and instructions online.