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Form DMHC20-224 Independent Medical Review (Imr) Application / Complaint Form - California (Japanese)
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 Japanese. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is the DMHC20-224 form?
A: The DMHC20-224 form is the Independent Medical Review (IMR) Application/Complaint Form.
Q: What is the purpose of the DMHC20-224 form?
A: The purpose of the DMHC20-224 form is to request an independent medical review when there is a dispute regarding a medical necessity determination.
Q: Can I file the DMHC20-224 form in languages other than English?
A: Yes, the DMHC20-224 form is available in languages other than English, including Japanese.
Q: What should I do if I have a complaint or dispute regarding a medical necessity determination?
A: You should fill out the DMHC20-224 form to request an independent medical review (IMR) to resolve the dispute.
Q: Is the DMHC20-224 form specific to California?
A: Yes, the DMHC20-224 form is specific to California and is provided by the California Department of Managed Health Care (DMHC).
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.
Download Form DMHC20-224 Independent Medical Review (Imr) Application / Complaint Form - California (Japanese)
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