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DMHC Regulates Health Plans and Helps Health Plan Members and Providers

Panel Title IconFor Health Plan Members

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Californians have the strongest patient's rights laws in the nation. DMHC’s Help Center is available to explain your health care rights and help you understand how to use your health care benefits. The Help Center can also resolve problems you may have with your health plan.

Panel Title IconFor Health Care Providers

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Ensuring prompt and fair payment of health care providers is critical to the stability of California's health care delivery system.  The DMHC’s Provider Complaint Unit can assist California physicians; hospitals and other licensed health care providers resolve disputed claim issues with payers.

Panel Title IconFor Health Plans

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The DMHC licenses and regulates California health plans and strives to streamline the process health plans must follow to comply with the law. This section has all the information and forms plans need to ensure compliance.

What's New

Disability Access

Monday, July 14, 2014
The DMHC works to ensure Californians with disabilities have the necessary information to successfully navigate the changing health care system. In conjunction with the Western University of Health Sciences, Harris Family Center for Disability and Health Policy, the DMHC developed the following educational materials for individuals with disabilities, including physical, developmental, intellectual and sensory disabilities. These materials are available for download and distribution. More ...

Fraud Complaint Form

Wednesday, May 14, 2014
In light of the rapidly changing health care market, the DMHC wants to make sure consumers are protected from deception or fraudulent marketing practices. The DMHC Fraud Complaint form is available to report scams or deceptive practices in the marketing and sale of health insurance products. The form is available in 15 languages. More ...

 

Learn About...

  • DMHC
  • Rate Review
  • Consumer Assistance
  • Independent Medical Review (IMR)
  • Medical Loss Ratio

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