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Claims Reconsideration and Appeals


Claims Reconsiderations/Adjustments

To view up to date Claim Reconsideration information go to

Claim Administrative Disputes/Appeals

If you are not satisfied with the outcome of a Claim Reconsideration Request, you may submit a formal Claim Dispute/Appeal using the process outlined in your provider manual.

A formal Claim Dispute/Appeal is a comprehensive review of the disputed claim(s), and may involve a review of additional administrative or medical records by a clinician or other personnel.

Please allow 10 business days from the submission date to enable us to begin processing the review before requesting a status update

Additional state requirements may apply. Please consult the applicable state Provider Administrative Guide or Manual for more details.

For more information please contact the provider services center.