Filing a Grievance

Internal Grievance Process

Magnolia wants to fully resolve your problems or concerns. Magnolia will not hold it against you or treat your child differently if you file a grievance. A grievance is an expression of dissatisfaction about any matter or aspect of Magnolia operation, other than an adverse benefit determination. Grievances may be received orally or in writing and may be submitted to Magnolia by you or your authorized representative, including your child’s provider. Grievances must be submitted to Magnolia within 45 days of the incident.

How to File a Grievance

Filing a grievance will not affect your child’s healthcare services. We want to know your concerns so we can improve our services.

To file a grievance, call member services at 866-912-6285 (Relay 711). Magnolia will provide reasonable assistance to members in filing a grievance. You can also write a letter and mail or fax your grievance to Magnolia at 877-264-6579. Be sure to include:

• Your child’s first and last name
• Your child’s Member ID number
• Your child’s address and telephone number
• What you are not pleased with
• What you would like to have happen

A grievance may be filed in writing by mailing it to the address below or by faxing it to 877-264-6579. You can also call us at 866-912-6285 or file the grievance in person at:

Magnolia Health
Grievance and Appeal Coordinator
111 East Capitol Street, Suite 500
Jackson, MS 39201

If you file a written grievance, the Grievance and Appeal Coordinator (GAC) will send you a letter within five (5) days letting you know that we have received your grievance. If you submit your grievance by phone or in person, there is no need for written acknowledgement.

If someone else is going to file a grievance for your child, we must have your written permission for that person to file your child’s grievance or appeal. You can call member services to receive a form or go to [WEBSITE]. This form gives your right to file a grievance or appeal to someone else. A provider acting for your child can file a grievance or appeal for your child.

If you have any proof or information that supports your grievance, you may send it to us and we will add it to your child’s case. You may supply this information to Magnolia by including it with a letter, by sending us an email or a fax, or by bringing it to Magnolia in person. You may also request to receive copies of any documentation that Magnolia used to make the decision about your child’s care, grievance, or appeal.

To review your request, we may need to obtain additional information. If a signed authorization to release information form is not included with your child’s grievance, a form will be sent to you for signature. If a signed authorization is not provided within 30 business days of the request, Magnolia may issue a decision on the grievance without review of some or all of the information. Appropriate proof of your designation must be provided when a signed request is submitted by your child’s authorized representative.

You can expect a resolution and a written response from Magnolia within 30 days after receiving your child’s grievance. If Magnolia needs more than 30 days to resolve the grievance, we will contact you with in two (2) working days to confirm approval.

There will be no retaliation against you, your child or your representative for filing a grievance or appeal with Magnolia.

Filing a grievance will not affect your child’s healthcare services.