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Blue Shield of California is a mutual benefit corporation and health plan [6] [7] founded in 1939 by the California Medical Association. It is based in Oakland, California, and serves 4.5 million health plan members and more than 65,000 physicians across the state. Blue Shield of California was founded as a not-for-profit organization.
The Medical Board of California (MBC) is a state government agency which licenses and disciplines physicians, surgeons and certain allied healthcare professionals in California. The Board provides two principal types of services to consumers: (1) public-record information about California-licensed physicians, and (2) investigation of complaints ...
The DMHC Help Center provides direct assistance in all languages to health care consumers through the Department’s website, www.HealthHelp.ca.gov, and a toll-free phone number, 1-888-466-2219. Mary Watanabe is currently the director of the DMHC. The DMHC is part of the California Health and Human Services Agency. It was established in 2000 ...
Medi-Cal Dental paid to the doctors only 30% of what commercial insurers paid for the same procedures per October 2017 report; even though DHCS must annually review reimbursement levels for Medi-Cal dental services to ensure “reasonable access” for Medi-Cal beneficiaries pursuant to Welfare & Institutions Code §14079 [8]
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In 2013, the Healthy Families Program was folded into Medi-Cal as part of the Affordable Care Act. 2005-2016 Healthy Kids. Partnership HealthPlan also offered a health insurance product called Healthy Kids to low income children not otherwise eligible for Medi-Cal. [ 8 ] In 2016, the Healthy Kids Program was folded into Medi-Cal under ...
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). The NPI has replaced the Unique Physician Identification Number (UPIN) as the required identifier for Medicare services, and is used by other payers ...
In 2008, Health Net agreed to pay $215M to settle allegations that it had unfairly reimbursed out-of-network providers between 1995 and 2007. [ 25 ] In September 2012, the Los Angeles County Medical Association and two patients sued Health Net for denying medically necessary treatment, including cancer care. [ 26 ]