Grievance Form (California DHMO Members only)

Grievance Information

This form is for California DHMO Members only.

on card

The Identification Number is the same for everyone covered on this policy.


Dentist Information

Grievance Process

The California Department of Managed Health Care is responsible for regulating health care service plans.

If you have a grievance against your health plan, you should first telephone your health plan at 1 866-357-3304 (and use your health plan's grievance process before contacting the department).

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Grievance Resolution Procedure