​​​We are receiving a high volume of claim review requests inappropriately sent to the member appeals fax number. Misdirected requests can cause delays in processing.

Providers and their third-party vendors must adhere to the proper submission channel for claim review requests.

If you have a claims-related issue, please use the Practice Management application on the PEAR portal to submit a Claim Investigation request via the Claim Search transaction. Review the Claim Search & Investigation user guide in the PEAR Help Center for assistance.

As a reminder, the member appeals fax number should only be used when you are submitting an appeal on the member's behalf.

Examples include:

• Provider appeals on behalf of the member with a valid member consent form.
• ​Expedited preservice appeals on behalf of the member.​

For all other appeal types, follow the appeal submission procedures outlined in the Appeals section of the Provider Manual or the Clinical Services – Utilization Management section​ of the Hospital Manual.

Thank you in advance for ensuring the appropriate channel is used when submitting future appeal requests.

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