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.
Q: What is form DMHC20-224?
A: Form DMHC20-224 is the Independent Medical Review (IMR) Application/Complaint Form used in California.
Q: What is Independent Medical Review (IMR)?
A: Independent Medical Review (IMR) is a process used in California to resolve disputes between patients and their health insurance providers.
Q: Who can use form DMHC20-224?
A: Any resident of California who is dissatisfied with a decision made by their health insurance provider can use form DMHC20-224 to request an Independent Medical Review (IMR).
Q: What should be included in form DMHC20-224?
A: Form DMHC20-224 should include the patient's contact information, health insurance information, a description of the medical treatment or service in question, supporting documentation, and any additional relevant details.
Q: How long does the Independent Medical Review (IMR) process take?
A: The IMR process typically takes up to 30 days for standard cases and up to 72 hours for expedited cases.
Q: Is there a cost to submit form DMHC20-224?
A: No, there is no cost to submit form DMHC20-224 for an Independent Medical Review (IMR) in California.
Q: What happens after submitting form DMHC20-224?
A: After submitting form DMHC20-224, the California Department of Managed Health Care (DMHC) will review the application and determine if an Independent Medical Review (IMR) is warranted.
Q: Can I appeal the decision made by the Independent Medical Review (IMR) process?
A: No, the decision made through the IMR process is final and binding for both the patient and the health insurance provider.
Q: Is the Independent Medical Review (IMR) process confidential?
A: Yes, the IMR process is confidential, and the patient's information is protected under state and federal privacy laws.
Form Details:
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.