What happens if a claim is denied?
You will be sent an EOB, stating why the claim was denied, and given information about what steps, if any, you might take to validate the claim. 125MAX will further advise you of your right to request an administrative review of the denial of the claim; you may request a review any time within the 60-day period after you have received notice that the claim was denied. You or your authorized representative will have the opportunity to review any important documents held by125MAX, and to submit comments and other supporting information. In most cases, a decision will be reached within 60 days of the date of your request for a review.
