Legal Question in Health Care Law in California

I was told by the insurance company and the Department of Managed Health Care (DMHC) in California that since my dentist is not a "contracted provider" [which is untrue I believe as my dentist can be chosen as a HMO provider on their website] and that the insurance company doesn't handle appointments, that I have no right to timely access to a dentist appointment within 15 business days. The section of the law can be found at http://wpso.dmhc.ca.gov/regulations/docs/15ccrp.pdf Do I have a case here?


Asked on 9/29/16, 6:50 pm

1 Answer from Attorneys

No you do not, for a host of reasons, but let's just go with a simple one. You are looking at the law regarding doctors. Dentists are not, as you have already been told, "contracted providers." Medical providers and dentists are completely separately regulated. Laws and regulations governing medical HMOs are irrelevant to dental HMOs even when administered by the same insurance company.

Read more
Answered on 9/29/16, 7:26 pm


Related Questions & Answers

More Health Care Law questions and answers in California