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

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This is a legal form that was released by the California Department of Managed Health Care - a government authority operating within California.

The document is provided in Farsi. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is the DMHC20-224 Independent Medical Review (IMR) Application/Complaint Form?
A: The DMHC20-224 form is a specific application/complaint form for requesting an Independent Medical Review (IMR) in the state of California.

Q: What is an Independent Medical Review (IMR)?
A: An Independent Medical Review (IMR) is a process in California where an independent organization reviews a denied healthcare service or treatment to determine if it should be approved or denied.

Q: Who should use the DMHC20-224 Independent Medical Review (IMR) Application/Complaint Form?
A: California residents who have been denied a healthcare service or treatment by a health plan or insurer can use the DMHC20-224 form to apply for an Independent Medical Review.

Q: What language is the DMHC20-224 Independent Medical Review (IMR) Application/Complaint Form available in?
A: The DMHC20-224 form is available in Farsi (Persian) language for individuals who prefer to use that language.

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;

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.