Independent Medical Review of Health Plan Decisions

California health-plan members enrolled in HMOs are entitled to an independent medical review (IMR) free of charge through the California Department of Managed Health Care (DMHC).  The IMR is essentially a second opinion, made by medical doctors, outside their health plan and expert in the particular area of medicine.  In essence, an IMR is when doctors tell the HMO what to do, not the other way around.

Millions of Californians can benefit from IMRs.  For example, it can provide an impartial review of a denial of care for an experimental treatment, many times within a matter of days, especially in urgent cases.  All a patient has to do is call the California HMO Help Center at 1-888-HMO-2219 or apply online at www.hmohelp.ca.gov

Responsible Limits
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