We’re committed to providing quality and cost effective health care services to our members. Our decisions are based only on existence of coverage and appropriateness of care.
Before beginning the reconsideration and appeals process, treating providers can request a Peer-to-Peer discussion with a doctor to review details of the member’s condition and care options.
Expedited Appeals are available for members who are at a more urgent risk for severe health issues without the previously requested care or service. You can request an expedited appeal by calling the prior authorization number for the plan that covers your patient.