Billing or Account Inquiry Form
For inquiries involving a WDS contracted provider other than a Western Dental Center,
please call Western Dental's Member Services at (800) 992-3366 between 8:30 am and
5:00 pm (Pacific time).
* Indicates Required Fields
Have you discussed your inquiry with the office manager?
This form is to be used for inquiries involving your Western Dental account. If
you have other questions or concerns, you may contact Western Dental's Member Services
at (800) 992-3366 or complete a Member
"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 1-800-992-3366 and use your Health Plan's
grievance process before contacting the Department. Utilizing this grievance procedure
does not prohibit any potential legal rights or remedies that may be available to
you. If you need help with a grievance involving an emergency, a grievance that
has not been satisfactorily resolved by your Health Plan, or a grievance that has
remained unresolved for more than 30 days, you may call the Department for assistance.
You may also be eligible for an Independent Medical Review (IMR). If you are eligible
for IMR, the IMR process will provide an impartial review of medical decisions made
by a Health Plan related to the medical necessity of a proposed service or treatment,
coverage decisions for treatments that are experimental or investigational in nature
and payment disputes for emergency or urgent medical services. The Department also
has a toll-free telephone number (1-888-HMO-2219) and a TDD line (1-877-688-9891)
for the hearing and speech impaired. The Department's Internet Web site http:/www.hmohelp.ca.gov
has complaint forms, IMR application forms, and instructions online."