Check out the updated Reviews & Appeals section of our Provider Manual

Yesterday, we launched a revamped, reorganized Reviews & Appeals section here in our Provider Manual. We did this with one goal in mind: making it easier for you, our providers, to work with us, care for our members and get paid fairly and accurately.

What's new?

The updated section features processes and information broken down into two main categories:

  • Claim reviews and appeals
  • Authorization reviews and appeals

Each category is divided into processes for Medicare and non-Medicare (commercial, individual / ACA and Medicaid), covering both medical and behavioral health.

Check out Reviews & Appeals