This version of the form is not currently in use and is provided for reference only. Download this version of Form DMHC20-224 for the current year.

Form DMHC20-224 Independent Medical Review (Imr) Application / Complaint Form - California

Preview

Fill PDF Online

PDF

Word

Fill PDF Online

Fill out online for free

without registration or credit card

What Is Form DMHC20-224?

This is a legal form that was released by the California Department of Managed Health Care - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is DMHC20-224?A: DMHC20-224 is the Independent Medical Review (IMR) Application/Complaint Form used in California.

Q: What is the purpose of DMHC20-224?A: The purpose of DMHC20-224 is to request an independent medical review or file a complaint in California.

Q: Who can use DMHC20-224?A: DMHC20-224 can be used by California residents who have a dispute with their health insurance plan's decision regarding medical treatment or service.

Q: What is an independent medical review?A: An independent medical review is a process where an independent third party reviews a health insurance plan's decision regarding medical treatment or service.

Q: Is there a deadline for submitting DMHC20-224?A: Yes, there is a deadline for submitting DMHC20-224. It is generally within 6 months from the date of the health insurance plan's final decision.

Q: What happens after I submit DMHC20-224?A: After you submit DMHC20-224, the California Department of Managed Health Care will review your application and determine if an independent medical review is necessary.

Form Details:

Released on August 1, 2018;
The latest edition provided by the California Department of Managed Health Care;
Easy to use and ready to print;
Available in Spanish;
Quick to customize;
Compatible with most PDF-viewing applications;
Fill out the form in our online filing application.

Download a printable version of Form DMHC20-224 by clicking the link below or browse more documents and templates provided by the California Department of Managed Health Care.