Health plan information, help with complaints, grievances, health coverage, health insurance, denials, independent medical review, external review

Independent Medical Review & Complaint Process. If your Health Plan denies, changes or delays your request for medical services, denies payment for emergency treatment or refuses to cover experimental or investigational treatment for a serious medical condition, you can apply for an Independent Medical Review (IMR).

Use the health plan dashboard to view or compare health plan information. The health plan dashboard features health plan contact information, enrollment data, complaint and IMR data, enforcement actions, and financial data.

Nov 26, 2024 · Services Submit an IMR/Complaint Form. If your health plan denies, changes or delays your request for medical services, denies payment for emergency treatment or refuses to cover experimental or investigational treatment for a serious medical condition, you can apply for an Independent Medical Review (IMR).

Department of Health Care Services. Governor's Budget Proposal 2025-26. The proposed 2025-26 Governor's Budget for DHCS allocates $193.4 billion in total funds, including $42.8 billion from the General Fund, and supports 4,821.5 positions.

The Department of Managed Health Care (DMHC) is a regulatory body governing managed health care plans, including Health Maintenance Organizations (HMOs) and most Medi-Cal managed care plans in California.The DMHC was created as the first state department in the country solely dedicated to regulating managed health care plans and assisting consumers to …

Nov 22, 2024 · Department of Health Care Services. Medi-Cal Managed Care and Mental Health Office of the Ombudsman. The Medi-Cal Managed Care and Mental Health Office of the Ombudsman helps solve problems from a neutral standpoint to ensure that our members receive all medically necessary covered services for which plans are contractually responsible.

5 days ago · Medical Audits and Corrective Action Plans. The Department of Health Care Services (DHCS) works with the Department of Managed Health Care (DMHC) to conduct routine medical surveys of Medi-Cal Managed Care Health Plans (MCPs) on …

Email: If you have questions about the complaint process or need more information, please email us at [email protected] you already have a case open with the DMHC, be sure to include your case number with any questions you submit.

mcp code dir 6 Part 1 – MCP: Code Directory Page updated: November 2024 MCP Code Directory Table (continued) County County Code Health Care Plan (HCP)

476 Ninth Street Oakland, California 94607 Tel: (510) 238-1040 Fax:(510) 238-1388 www.chcf.org Printed on recycled paper. Acknowledgments

The California Chronic Care Coalition (CCCC) launched this website in California and expanded it nationwide to help people who have been denied treatment or medicines, experienced delays or are dissatisfied with the decisions made by their health plan.. The information found here including but not limited to, text, graphics, images and all other material contained on this website is for ...

Feb 29, 2024 · California’s Department of Managed Health Care announced its investigation into Kaiser in May 2022, when the agency received an unusual number of “complaints received from enrollees, providers, and other stakeholders concerning the plan’s behavioral health operations.”. Just three months later, a union representing 2,000 Kaiser Northern California mental health …

Office of Plan Licensing. As part of the licensing process, the Office of Plan Licensing (OPL) reviews all aspects of a health plan’s operations, including benefits and coverage (Evidences of Coverage), template contracts with doctors and hospitals, provider networks, mental health parity and complaint and grievance systems.

Use the health plan dashboard to view or compare health plan information. The health plan dashboard features health plan contact information, enrollment data, complaint and IMR data, enforcement actions, and financial data.

Aug 30, 2024 · State health regulators have fined Blue Shield of California $250,000 for illegally charging hundreds of its members for contraceptive health care services.. The insurance company also paid $228,254 in reimbursements to the members who were incorrectly billed, the California Department of Managed Health Care announced on Thursday.

Introduction. Both state and federal laws require health plans to provide treatment for mental health and substance use disorder conditions. The DMHC refers to treatment and services provided to treat mental health and substance use conditions as behavioral health care.

Gavin Newsom, Governor State of California Health and Human Services Agency DEPARTMENT OF MANAGED HEALTH CARE 980 9th Street, Suite 500 Sacramento, CA 95814 Phone: 916-324-8176 | Fax: 916-255-5241

Capitated Providers. DMHC # Name. Address. City. State. Zip. 10522. Access IPA 1336 W. Whittier Blvd. Montebello CA 90640 10001 Access Medical IPA, Inc. 2300 East Katella Ave., Suite 325 Anaheim CA 92806

Transgender, Gender Diverse, or Intersex (TGI) Health Care Quality Standards and Training Curriculum Listening Session . September 27, 2023 2:00 p.m. – 4:00 p.m.