• DMHC Launches New Online Portal to Make It Easier for Californians to Resolve Disputes with their Health Plan

    Posted on December 24, 2012 by in Breaking News

    Life Insurance, Medicare, CJB Insurance

    Department of Managed Health Care Press Release by Brent A. Barnhart

    December 04, 2012

    Portal made possible through federal Affordable Care Act grant funding

    (Sacramento) The California Department of Managed Health Care (DMHC) today launched a new secure, easy-to-use online form to allow Californians to file complaints regarding their health plan quickly and easily from any computer. The portal, available in both English and Spanish, enables consumers to request an external review of a health plan’s denial of medical services, known as an Independent Medical Review. Previously, health plan enrollees had to submit the required forms and paperwork via mail or fax.

    “With more Californians to gain health care coverage under the Affordable Care Act, this new online portal will ensure there is a fast and easy way for them to get the care they are entitled to,” said Diana S. Dooley, Secretary of the California Health and Human Services Agency.

    Each year, the DMHC receives and resolves approximately 4,000 complaints from health plan members. Topics range from issues relating to access to care, claims, enrollment, benefits or coordination of care. Additionally, the DMHC annually administers approximately 1,700 Independent Medical Reviews of a health plan denial of service. These reviews are conducted by independent doctors not affiliated with the health plan.

    “This new online portal will help more Californians take advantage of the free health care assistance available through the Department of Managed Health Care’s Help Center,” said Brent Barnhart, DMHC Director.

    The DMHC also unveiled two new online videos explaining the services available through the DMHC Help Center: 
    About the DMHC

    The DMHC regulates managed care health plans in California, protects the rights of approximately 20 million health plan enrollees, educates consumers on their health care rights and responsibilities, and preserves the financial stability of the managed health care system. Since 2000, the department has helped more than 1 million Californians resolve health plan problems through its Help Center. Information and assistance is available 24/7 at www.HealthHelp.ca.gov or by calling 1-888-466-2219.

    Source: John & Rusty Report via Word & Brown

     

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