Sample Appeal Letter-
62 page guide - DOI Washington State

Sample Appeal Letter

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Specimen EOC Evidence of Coverage - Appeals - Grievances


California Health Care Foundation on IMR The California Department of Managed Health Care (DMHC)  The DMHC regulates HMOs and some PPOs in California  – Try using the Insurance Company procedure first

Complaint Form IMR


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Contact Form

CA Department of Insurance  

IMR – Independent Medical Review  

ONLINE complaint form  Fillable Claim Form   


8 comments on “Independent Medical Review

  1. What would be the appropriate venue for a Knox Keene Violation involving a disabled child.

    We are enrolled in a locally governed managed medical plan & no one seems to understand that it always applies to a disabled child.

    We passed IMR.

    They took away my kids best treatment.

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