Commercial
You must wait 45 days after submitting a claim to request a review, and you must use the review process before you can file an appeal.
Note: An informal claim review decision is required to process an appeal.
Non-Medicare claims reviews & appeals
Page last updated on: 6/20/25
Medicaid
For the most part, reviews and appeals under Medicaid follow our process for commercial plan reviews and appeals, with the addition of the binding arbitration process.
Note: An informal claim review decision is required to process an appeal.