Provider Appeals

Submit appeals through InTouch

Provider appeals help us improve our products and the health of our communities. The best way to submit appeals is through InTouch, which can be accessed through OneHealthPort. To ensure a timely response, please include all relevant documentation such as medical records and justification for services.

You can also mail or fax your appeal following the instructions on the appropriate form below.

Commercial appeal form

Medicaid appeal form

Medicare appeal form

Appeals procedure, policies, and details

You can find detailed information about appeals in the provider manual, including:

Provider grievances
Member grievance and appeals
Appeal form requirements
Prior Authorization appeals
Prescription coverage appeals
Claims appeals
Appeals resolutions
Noncontracted provider appeals

Questions about appeals?

Please contact your Provider Service Representative.