Reviews & appeals
In the pages linked below, you’ll find detailed instructions on how to ask us to reconsider a decision we’ve made, whether coverage and payment or authorizations denials.
Claim reviews & appeals
Use the instructions on the pages below to submit reviews and appeals requests for medical and behavioral health claims.
Note: An informal claim review decision is required to process an appeal.
Authorization reviews & appeals
Use the instructions on the pages below to submit reviews and appeals requests for a denied medical and behavioral health authorizations.
Note: If you have a denied medical or behavioral health authorization on file, submit a medical or behavioral health authorization appeal – not a post-claim review request.
What makes a good appeal?
Our Reimbursement team shares what you can and can't appeal, what to include in your appeal, how to request reviews for multiple claims and more.
Provider manual
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