Appeals Process

We’re here to help.

 

Provider Claim Inquiry Process

If you have questions about a claim, or need help with claim processing, there are three ways that we support you.

Service Operations - 888-806-3400

This is your first step, and the quickest way to get your claims question answered.

Provider Service Team

The Service Operations team member may escalate your question to this team if we aren’t able to answer your question at the time you call. A reply may take up to five (5) business days.

Provider Inquiry Process

Use this written process if a claim remains unresolved to your satisfaction. You have 180 days from the date you received the explanation of payment (or per your provider agreement) to write us. We’ll review and respond to you within thirty (30) days.

For more details and mailing instructions, please refer to your Provider Handbook.