How do I appeal a certification or authorization denial, or a claim payment or denial?
As a member, you have a right to express dissatisfaction and to expect unbiased resolution of issues. The following represents the process established to ensure that we give our full attention to your concerns. Please utilize it to tell us when you are displeased with any aspect of services rendered. Fax the details of your request, along with supporting documentation, to 1.877.868.7950. You may also call customer care at the phone number listed on your member ID card. Tell us your problem and we will work to resolve it for you as quickly as possible. If you are not satisfied with our answer, you may file a formal complaint, preferably, but not necessarily, in writing. This request for a further review of your concerns should be faxed to 1.877.868.7950 or may be provided by contacting customer care using the number on your member ID card.
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