Treatment class · subcategory · California
General Anesthesia denials at external review
When a California health plan denied care in the general anesthesia class and the enrollee took it to Independent Medical Review, this is what independent physician reviewers decided.
45.5%
- Overturned
- 15 of 33
- Era
- 2021-2025
- Jurisdiction
- California DMHC IMR
- Published class
- General Anesthesia
- Median days to decision
- 47
- All years
- 25.7% of 148
15 overturned18 upheld
By condition
computed- Overturned — the reviewer did not sustain the denial
- Upheld — the reviewer sustained the denial
- Prevention & wellness—14
- Digestive & GI—13
- Dental—3
- Cancer—1
- Endocrine & metabolic—1
- Mental health—1
The specific conditions inside this class
below n=30, no rate is claimed- Not classified—14
- Other—4
- Polyps—2
- Abdominal/Stomach Pain—1
- Abscess/Infection—1
- Anxiety—1
- Chronic Diarrhea—1
- Colon—1
Every figure on this page is conditional on a denial having reached external review. Fewer than 1% of denials are appealed internally at all, so this describes denials that were fought to the end — not denials in general — and it describes California only. Who this does not cover.
Free help, first: the California DMHC Help Center files your Independent Medical Review at no cost — 1-888-466-2219, dmhc.ca.gov.