Ninety-eight percent of our member concerns are resolved with a single phone call. Before pursuing an appeal, call us for help.
For general questions, contact Member Services.
Experienced nurse navigators can help solve concerns about benefits. Call Member Services and ask to speak to a nurse navigator Monday - Friday, 7:30 a.m. to 6 p.m.
If your authorization for medical care was denied based on our medical coverage criteria, you or your doctor have the right to discuss the decision with a clinician in our authorization department. Call our medical appeals telephone line at 800-331-8643 for help.
If we can’t resolve your concern with a telephone call within 10 days, we’ll help you complete an appeal form.
If your appeal involves urgently-needed care, call Member Services to expedite the appeal, and we will respond within 72 hours.
Medicare plans or a pre-paid medical assistance plan may require a different appeal process. Call the Member Services number located on your insurance card for more information.