Search results with tag "Claim single"

Provider reconsideration, appeal and grievance instructions

Mar 15, 2022 · • Submit a claim form marked “RECONSIDERATION” at the top with the completed Provider Dispute and Resubmission form found on the last page. • Include additional information required to reconsider the claim single sided. • Refer to the provider manual for provider filing timeframes. Submit reconsiderations to:

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