Provider Forms

Member Appeals & Grievances

The SFHP Grievance process is designed to resolve member concerns in a manner that is accessible, timely and thorough. A Member Grievance is any written or oral expression of dissatisfaction regarding the plan or provider, including quality of care concerns, and may include a complaint, dispute, request for reconsideration or appeal made by a member or member’s representative. The grievance process is available across all lines of business, though specific procedures apply only to Medi-Cal members. SFHP will provide a written resolution within 30 days.

The Grievance Forms are available in all 5 threshold languages – English, Spanish, Chinese, Vietnamese, and Russian. We ask that providers have grievance forms available for members in their office or you can refer members to the website. Our Customer Service is available to help providers and members with any grievance or complaint. You can call us at 1(415) 547-7800 or 1(800) 288-5555.

You may also file a grievance in person. Our Service Center address is 7 Spring Street, San Francisco, CA, 94104. Office Hours 8:00am to 5:30pm Monday through Friday. Call 1(415) 777-9992 to schedule an appointment.