California's Independent Medical Review (IMR) process provides patients with an opportunity to obtain an external review of treatment decisions made by HMOs and other types of managed care organizations. There is no cost to the enrollee. Requests for IMR are made directly to the DMHC with a minimum amount of administrative hassle or paperwork for the patient or providers. The information in this section describes the IMR process, the types of disputes eligible for an IMR, the time frame for decisions, the selection of independent reviewers and the foms needed to complete an IMR. IMR information for providers will help doctors to assist patients in requesting this treatment review.