i emailed the people managing my cases at the DMHC to find out if this is just another round of bullshit blue shield is gonna pull that the DMHC will have to intervene in. hopefully thats it but like. if i was supposed to file claims blue shield already said theyd deny while appealing said denial...
February 25, 2026 at 3:05 AM
i emailed the people managing my cases at the DMHC to find out if this is just another round of bullshit blue shield is gonna pull that the DMHC will have to intervene in. hopefully thats it but like. if i was supposed to file claims blue shield already said theyd deny while appealing said denial...
anyway, feeling depressed bc i didnt get a bottom surgery date and am starting to feel like the dmhc is trying to tank my slam-dunk case against blue shield, so im posting too much and spending too much money on skincare products
February 6, 2026 at 12:43 AM
anyway, feeling depressed bc i didnt get a bottom surgery date and am starting to feel like the dmhc is trying to tank my slam-dunk case against blue shield, so im posting too much and spending too much money on skincare products
btw cali girlies: if youre having trouble getting reimbursement or prior auths from your health insurance, check if your plan is regulated by the DMHC. if it is you can appeal denials to them, ask for independent medical reviews, and basically force your insurance to justify themselves to the state
theyre pretty awful if youre seeking reimbursement but ime dont make much fuss if theyre being billed by someone in-network, esp bigger medical systems (eg ucla)
but for reimbursement of claims you can call in the state to bully them, which ive recently had some success with
but for reimbursement of claims you can call in the state to bully them, which ive recently had some success with
June 5, 2026 at 7:08 PM
btw cali girlies: if youre having trouble getting reimbursement or prior auths from your health insurance, check if your plan is regulated by the DMHC. if it is you can appeal denials to them, ask for independent medical reviews, and basically force your insurance to justify themselves to the state
blue shield: haha yeah sorry we um actually did all of that shit you said despite it being against the law ha ha our bad lol
me: so um.. you see? they admit it?
ca dmhc: oof idk. this is just. wow theres so much. um. legal complexity
me: so um.. you see? they admit it?
ca dmhc: oof idk. this is just. wow theres so much. um. legal complexity
February 6, 2026 at 12:51 AM
blue shield: haha yeah sorry we um actually did all of that shit you said despite it being against the law ha ha our bad lol
me: so um.. you see? they admit it?
ca dmhc: oof idk. this is just. wow theres so much. um. legal complexity
me: so um.. you see? they admit it?
ca dmhc: oof idk. this is just. wow theres so much. um. legal complexity
Bij DMHC … eerste wedstrijd 2-0 verloren, tweede wedstrijd halverwege 1-0 voor
March 16, 2025 at 12:28 PM
Bij DMHC … eerste wedstrijd 2-0 verloren, tweede wedstrijd halverwege 1-0 voor
even if the DMHC only gets some of the requested procedures approved by the time you have to pay up, it means your insurance company will have to sign an LOA to take care of those costs and the facility fees, which means less you’ll need to seek reimbursement for later
June 5, 2026 at 7:21 PM
even if the DMHC only gets some of the requested procedures approved by the time you have to pay up, it means your insurance company will have to sign an LOA to take care of those costs and the facility fees, which means less you’ll need to seek reimbursement for later
oh yeahhh i'm fighting them for a procedure they literally approved last year and now blanket deny
about to submit my DMHC claim UGH
about to submit my DMHC claim UGH
June 5, 2026 at 7:03 PM
oh yeahhh i'm fighting them for a procedure they literally approved last year and now blanket deny
about to submit my DMHC claim UGH
about to submit my DMHC claim UGH
this message is brought to you by a trans girl who just got a big fat check covering almost all of the costs of one of her ffs surgeries thanks to the DMHC (theyre still fighting over the other surgery but its basically the exact same fight atp so im hopeful the outcome will be similar)
June 5, 2026 at 7:15 PM
this message is brought to you by a trans girl who just got a big fat check covering almost all of the costs of one of her ffs surgeries thanks to the DMHC (theyre still fighting over the other surgery but its basically the exact same fight atp so im hopeful the outcome will be similar)
but also ftr my recommendation if youre going out-of-network for surgery is get your surgeon to file the prior auth five months ahead of time, if you get denied file an appeal to the insurance co asap, and if thats denied go straight to the dmhc so they have 2-3mo to work it out
June 5, 2026 at 7:18 PM
but also ftr my recommendation if youre going out-of-network for surgery is get your surgeon to file the prior auth five months ahead of time, if you get denied file an appeal to the insurance co asap, and if thats denied go straight to the dmhc so they have 2-3mo to work it out
dmhc complaint
they have legal requirement to give you a reasonable estimate before the procedure inclusive of insurance coverage, and if the actual bill is more than a “small” difference ($500 iirc?) then you aren’t responsible for it under state law
they have legal requirement to give you a reasonable estimate before the procedure inclusive of insurance coverage, and if the actual bill is more than a “small” difference ($500 iirc?) then you aren’t responsible for it under state law
November 6, 2025 at 9:53 PM
dmhc complaint
they have legal requirement to give you a reasonable estimate before the procedure inclusive of insurance coverage, and if the actual bill is more than a “small” difference ($500 iirc?) then you aren’t responsible for it under state law
they have legal requirement to give you a reasonable estimate before the procedure inclusive of insurance coverage, and if the actual bill is more than a “small” difference ($500 iirc?) then you aren’t responsible for it under state law
iirc ~70% of appeals made to the DMHC result in some amount of payout, so as long as your insurance co has an on paper obligation to cover your procedures youre likely to get smth
and dw about like wasting public money or w/e: if the state deems an IMR necessary the insurance co has to pay for it
and dw about like wasting public money or w/e: if the state deems an IMR necessary the insurance co has to pay for it
June 5, 2026 at 7:11 PM
iirc ~70% of appeals made to the DMHC result in some amount of payout, so as long as your insurance co has an on paper obligation to cover your procedures youre likely to get smth
and dw about like wasting public money or w/e: if the state deems an IMR necessary the insurance co has to pay for it
and dw about like wasting public money or w/e: if the state deems an IMR necessary the insurance co has to pay for it
Sharing for any in this position:
20 states have protections for out-of-network ambulance costs in plans regulated by the state (including marketplace plans).
If truly no in-network providers, the insured may need to treat claim as in-network. Contact state dept of insurance (or DMHC if in CA)
20 states have protections for out-of-network ambulance costs in plans regulated by the state (including marketplace plans).
If truly no in-network providers, the insured may need to treat claim as in-network. Contact state dept of insurance (or DMHC if in CA)
Expanding the No Surprises Act to Protect Consumers from Surprise Ambulance Bills: Map of State Laws
www.commonwealthfund.org
December 20, 2025 at 8:27 PM
Sharing for any in this position:
20 states have protections for out-of-network ambulance costs in plans regulated by the state (including marketplace plans).
If truly no in-network providers, the insured may need to treat claim as in-network. Contact state dept of insurance (or DMHC if in CA)
20 states have protections for out-of-network ambulance costs in plans regulated by the state (including marketplace plans).
If truly no in-network providers, the insured may need to treat claim as in-network. Contact state dept of insurance (or DMHC if in CA)
I realize how immature my response is and I do not give one single fuck.
June 15, 2026 at 6:42 PM
I realize how immature my response is and I do not give one single fuck.
If I signed the waiver, why did you tell DMHC I didn’t and then complain to me that DMHC was asking you for money
May 31, 2023 at 12:06 AM
If I signed the waiver, why did you tell DMHC I didn’t and then complain to me that DMHC was asking you for money
Our overturn rate when we do an external appeal at the California DOI or DMHC is about 75%. And because it's a state agency, it's actually a little easier than doing internal appeals with the insurer. Hardest part is exhausting internal appeals with the insurer first.
December 11, 2024 at 9:25 PM
Our overturn rate when we do an external appeal at the California DOI or DMHC is about 75%. And because it's a state agency, it's actually a little easier than doing internal appeals with the insurer. Hardest part is exhausting internal appeals with the insurer first.
I am not a lawyer, but for those in California, DMHC requires plans it licenses to cover gender-affirming care. DMHC regulates the vast majority of plans in California. No word yet on subsidies. www.dmhc.ca.gov/HealthCarein...
www.dmhc.ca.gov
March 11, 2025 at 3:20 PM
I am not a lawyer, but for those in California, DMHC requires plans it licenses to cover gender-affirming care. DMHC regulates the vast majority of plans in California. No word yet on subsidies. www.dmhc.ca.gov/HealthCarein...
I am so sorry. Kaiser therapist here and it breaks my heart out patients not getting the support they deserve. If you run into problems getting care which is (888) 466-2219, call DMHC
November 18, 2024 at 4:25 AM
I am so sorry. Kaiser therapist here and it breaks my heart out patients not getting the support they deserve. If you run into problems getting care which is (888) 466-2219, call DMHC
with the DMHC and Anthem. 15 months but I got my money.
February 25, 2026 at 3:19 AM
with the DMHC and Anthem. 15 months but I got my money.
DETH DEKK DOMINIONS:🎧🆕🎧2⃣0⃣2⃣4⃣
SHATTERED REALM - Scars From Lessons Learned EP 🇺🇸 💢
4 Track EP from Asbury Park, New Jersey, U.S Death Metal/Hardcore outfit 💢
AL➡️ album.link/i/1782435044 💢
#ShatteredRealm #ScarsFromLessonsLearbed #DMHC #MetalSky #DDDDec1 #DethDekk #KMäN
SHATTERED REALM - Scars From Lessons Learned EP 🇺🇸 💢
4 Track EP from Asbury Park, New Jersey, U.S Death Metal/Hardcore outfit 💢
AL➡️ album.link/i/1782435044 💢
#ShatteredRealm #ScarsFromLessonsLearbed #DMHC #MetalSky #DDDDec1 #DethDekk #KMäN
December 3, 2024 at 11:04 PM
DETH DEKK DOMINIONS:🎧🆕🎧2⃣0⃣2⃣4⃣
SHATTERED REALM - Scars From Lessons Learned EP 🇺🇸 💢
4 Track EP from Asbury Park, New Jersey, U.S Death Metal/Hardcore outfit 💢
AL➡️ album.link/i/1782435044 💢
#ShatteredRealm #ScarsFromLessonsLearbed #DMHC #MetalSky #DDDDec1 #DethDekk #KMäN
SHATTERED REALM - Scars From Lessons Learned EP 🇺🇸 💢
4 Track EP from Asbury Park, New Jersey, U.S Death Metal/Hardcore outfit 💢
AL➡️ album.link/i/1782435044 💢
#ShatteredRealm #ScarsFromLessonsLearbed #DMHC #MetalSky #DDDDec1 #DethDekk #KMäN
time, but I won! Couldn’t be more grateful to DMHC for advocating for me and requiring BS to do what’s right. This is a business model for them- to deny care as much as possible so it’s more profitable for them. (Hence why for profit healthcare as a system is fucking insane.) my heart aches for 2/
March 3, 2025 at 7:52 PM
time, but I won! Couldn’t be more grateful to DMHC for advocating for me and requiring BS to do what’s right. This is a business model for them- to deny care as much as possible so it’s more profitable for them. (Hence why for profit healthcare as a system is fucking insane.) my heart aches for 2/
Oh my God, that damn tune.
I cracked up when I heard it at the end of DMHC with the freeze frame on that guy's face. Haha!
I cracked up when I heard it at the end of DMHC with the freeze frame on that guy's face. Haha!
July 28, 2025 at 12:31 AM
Oh my God, that damn tune.
I cracked up when I heard it at the end of DMHC with the freeze frame on that guy's face. Haha!
I cracked up when I heard it at the end of DMHC with the freeze frame on that guy's face. Haha!