How do I submit an adverse claim determination for review under the voluntary review procedure?
If you wish to pursue a voluntary review, you may write to the National Benefit Center (please refer to the contact list for the appropriate address). Your correspondence should include the initial Explanation of Benefits (EOB), the carriers responses to your appeal, the basis for requesting a determination and any pertinent documentation.
- If the provider is required to submit medical justification for a certain procedure either before the procedure or when filing the claim, how is that managed?
- How do I submit an adverse claim determination for review under the voluntary review procedure?
- What types of claims can I submit on a Full Review Final Payment Claim?