Submitting a Request for an Expedited Appeal or Reconsideration
Date Issued: 11/11/2015
An expedited appeal can be requested for situations where the patient’s health could be placed in serious jeopardy or their ability to regain maximum function could be impacted if the standard timeframe was applied.
Expedited appeals apply only to services that have not yet occurred or are ongoing, not in cases where services have already been provided. Because we process expedited appeals within 72 hours of the request, it is important that we get complete information from you to best serve our member(s), and your patient(s).
The quickest way to file an expedited appeal is to:
- Call 1-888-447-6855 to leave a voicemail
- Fax us at: 1-866-350-2168
For fax submissions, please include a copy of the initial adverse determination notice and all additional clinical information you want us to consider in the appeal. Please state the reason why you believe the member’s health is in serious jeopardy or why they are at risk of regaining maximum function if we were to apply the standard timeframe. If you call in the appeal to this voicemail box, we will contact you and ask that you provide this information as well.