Providers: Provider Resources: Grievance Process/
Member Grievance and Appeals Process
The SFHP grievance process is designed to resolve member and provider concerns in a manner that is accessible, timely, and thorough. With respect to members, the grievance process is available across all lines of business, though specific procedures apply only to Medi-Cal members. The grievance process is also used when a provider contests a claims payment, utilization management, or pharmacy authorization decision.
The links below contain information on our member grievance policy, multiple-language member grievance forms for your practices' waiting rooms, and a provider claim dispute form:
- Download Our Member Grievances and Appeals Policy
- Download a Member Grievance Form
- Download a Provider Claim Dispute Form
Accessibility Statement