Suggested Messaging: Sorina had to receive emergency health care services at an out-of-network hospital.
Afterward, her health care plan denied coverage of the services, leaving Sorina with a $27,000 hospital bill.
Through an appeal to the Department of Managed Health Care (DMHC), Sorina did not have to pay the bill. If your health care plan denies health care coverage, you can file an independent appeal with the DMHC.
First, file a complaint, sometimes called an appeal or grievance, with your health care plan. Then, after 30 days, if your health care plan denies your appeal, or you are unhappy with the outcome, you can contact the DMHC’s Help Center at DMHC.ca.gov or 1-888-466-2219.
The DMHC is an independent state agency not associated with your health care plan.
Appeals to the DMHC are successful in 7 out of 10 cases.
For more information, go to DMHC.ca.gov or call the Help Center at 1-888-466-2219.
Free help is available in all languages.