ACN Group of California, Inc. d/b/a OptumHealth Physical Health of California (Optum) does not discriminate on the basis of race, color, national origin, ancestry, religion, sex, marital status, gender, gender identity, sexual orientation, age or disability in its health programs or activities.

We provide assistance free of charge to people with disabilities or whose primary language is not English. To request this information in another format such as large print or to get language assistance such as a qualified interpreter, please call toll-free 800-428-6337, TTY 711, Monday through Friday, 8:30 a.m. to 5 p.m. PT.

If you believe that we have failed to provide these services or discriminated in another way on the basis of race, color, national origin, ancestry, religion, sex, marital status, gender, gender identity, sexual orientation, age or disability, you can file a grievance by mail or email to the Optum Civil Rights Coordinator, or directly to your health plan (Optum) by telephone, mail, online, or facsimile within 180 calendar days of becoming aware of the issue, as follows:

Optum® Civil Rights Coordinator 11000 Optum Circle Eden Prairie, MN 55344 Fax: 855-351-5495 Email: Optum_Civil_Rights@Optum.com

Grievance Coordinator OptumHealth Physical Health of California P.O. Box 880009 San Diego, CA 92168-0009 1-800-428-6337 (619) 641-7185 (Fax) www.myoptumhealthphysicalhealthofca.com

If you need help filing a grievance, please call toll-free 800-428-6337, TTY 711, Monday through Friday, 8:30 am – 5 pm PT.

The California Health and Safety code, Section 1368.02(b) requires Optum to provide you with the following information:

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 1-800-428-6337 or for TDDY services call 1-(888) 877-5379 (voice), or 1-(888) 877-5378 (TDDY) 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 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 (1-888-466-2219) and a TDD line (1-877-688-9891) for the hearing and speech impaired. The department’s internet website (http://www.dmhc.ca.gov) has complaint forms, IMR application forms and instructions online.

If you believe your health coverage has been, or will be improperly cancelled, rescinded, or not renewed, you may also call the Department for assistance.

You can also file a complaint directly with the U.S. Dept. of Health and Human services online, by phone or mail:
Online: https://ocrportal.hhs.gov/ocr/portal/lobby.jsf
Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.
Phone: Toll-free 1-800-368-1019, 800-537-7697 (TDD)
Mail: U.S. Dept. of Health and Human Services

This information is available in other formats like large print. To ask for another format, please call the toll-free member phone number listed on your health plan ID card, TTY 711, Monday through Friday, 8:30 a.m. to 5 p.m.