We are seeing a high-volume use of the member appeals fax number to submit non-member related appeal requests. The member appeals fax number should only be used when you are submitting an appeal on the member's behalf. For example, when the member has signed a consent form to have the provider submit the appeal.
The appeal submission procedures are outlined in the Appeals section of the Provider Manual or the Clinical Services – Utilization Management section of the Hospital Manual.
As a reminder, please also adhere to the Timely Filing requirements when submitting your request to avoid a rejection for untimely filing.
Thank you in advance for ensuring the appropriate channel is used when submitting future appeal requests.