№ files_lp_4_process_3_061599
Official notification of a delayed behavioral health service request detailing the member’s appeal rights and contact options for assistance from San Mateo County BHRS and the Medi-Cal Ombudsman.
Year: 2026
Region / City: San Mateo County, California
Subject: Behavioral Health Service Request
Document Type: Notice of Adverse Benefit Determination
Organization / Agency: San Mateo County Behavioral Health and Recovery Services (BHRS)
Recipient: Medi-Cal member
Requesting Provider: [Name of requesting provider]
Service Requested: Behavioral health service approval or provision
Date of Request: [date requested]
Appeal Information: Included in “Your Rights under Medi-Cal Managed Care”
Contact Information: Quality Management Department (650) 573-3431, California Relay Service (800) 855-7100, BHRS alternative formats (800) 288-5189
Ombudsman Contact: State Medi-Cal Managed Care Ombudsman Office 1-888-452-8609
Price: 8 / 10 USD
The file will be delivered to the email address provided at checkout within 12 hours.

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