Skip to Main Content

Appeals and Grievances

File a GRIEVANCE FORM – Mail or Fax

Download and print a GRIEVANCE FORM.

Mail completed form to:
California Health & Wellness
Attn: Appeals and Grievance
1740 Creekside Oaks Drive, Suite 200 
Sacramento, CA 95833

Fax completed form to: 1-855-460-1009

Additional forms:

File a GRIEVANCE FORM – Online

To file a GRIEVANCE FORM online, you must have an online account.

After you login, click, GRIEVANCE FORM.

Members – login here to file a GRIEVANCE FORM

If you don't have an online account, members can sign up for an online account. 

Sign Up Now


California Department of Managed Health Care (DMHC)

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 (1-877-658-0305) 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 (1-888-466-2219) and a TDD line (1-877-688-9891) for the hearing and speech impaired. The department’s internet website www.dmhc.ca.gov has complaint forms, IMR application forms and instructions online.