Denial Notification
Provider Type
- Physicians (does not apply to Cal MediConnect)
- Participating Physician Groups (PPG)
(does not apply to HSP)
- Hospitals
- Ancillary
This section contains general information for claims and service denials.
Select any subject below:
- Claims Denial Requirements
- Denial of Investigational or Experimental Treatment for a Terminal Illness
- Service Denial Templates
- Integrated Denial Notification - Notice of Denial Medical Coverage Template Information
- Notice of Medicare Non-Coverage and Detailed Explanation of Non-Coverage (Ancillary)
- Notice of Medicare Non-Coverage and Detailed Explanation of Non-Coverage (PPGs)
- Notification Delays
- Requirements for Notification of Utilization Management Decisions