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Dispute Resolution and Appeals

Provider Type

  • Physicians 
  • Hospitals
  • Ancillary

Providers have 180 days from the date a claim is adjudicated to file a dispute or appeal. Providers may submit appeals for the following reasons:

  • The provider believes that the claim was not reimbursed at the contracting rate and additional payment is requested.
  • The provider has received a request for reimbursement of an overpayment and the provider believes this is incorrect.
Last Updated: 06/23/2022