FRESNO UNIFIED RETIREES ASSOCIATION
Notice from the Department of Managed Health Care
The California Department of Managed Health Care (DMHC) is responsible for regulating health care service plans and specialized plans such as vision service plans. If you have a grievance against your vision service plan, you should first telephone your vision service plan at 800.877.7195 and use your vision service plan’s grievance process before contacting the department. Utilizing this grievance procedure does not prohibit any potential legal rights or remedies that may be available to you. If you need help with a grievance involving an emergency, a grievance that has not been satisfactorily resolved by your vision service plan or a grievance that has remained unresolved for more than thirty (30) days, you may call the department for assistance. You may also be eligible for an Independent Medical Review (IMR). If you are eligible for an IMR, the IMR process will provide an impartial review of medical decisions made by a vision service plan related to the medical necessity of a proposed service or treatment, coverage decisions for treatments that are experimental or investigational in nature, and payment disputes for emergency or urgent medical services. The department also has a toll-free telephone number (1-888-466-2219) and a TDD line (1877-688-9891) for the hearing and speech impaired. The department’s Internet Web site http://www.Healthhelp.ca.qov has complaint forms, IMR application forms and instructions online.
P.O. Box 1717
Clovis, CA 93613