Reminder: Claim dispute (appeal) decisions are delivered via prism

We’re sharing a reminder that claim dispute (appeal) decisions are sent through our provider portal, prism.

When we’ve posted a decision on your claim dispute (appeal), you’ll receive an email notification. To view the decision:

  1. Log into your prism account.
  2. Click Appeals in the main menu.
  3. Find and click the Inquiry ID in question.
  4. Scroll down to the Comments section to review the dispute decision and rationale.

We recently corrected our Provider Manual claim appeals information to reflect this long-standing process. The manual had previously stated decisions were delivered by letter, which hasn’t been the case for many years. We apologize for any confusion this may have caused.