Provider Portal:
Addressing Denied Claims

We know denied claims are not what you want to see. But if you get one and have a question about it, or believe it was denied in error or paid at the wrong rate, using the provider portal is a much better path forward than using mail, phone, or fax.

Need to address one of the following that are unrelated to a medical necessity determination?

• Claim inquiry.
• Grievance.
• Denial message request for records or supporting documents.

To start a new conversation about one of these issues, use the Claims Search feature rather than the Message Center.

Here are the steps to take to start a new conversation:

• Look up the claim. Note: the user’s portal account must be linked to the Tax ID used on the claim.
• Use the Ask a Question button.
• Select Category and Subcategory.
• Enter message.
• Attach requested and/or supporting documents. (Up to five.)
• Press Send.
• Make note of the Message ID and use the Message Center going forward.

Here are the steps to take to add more documents to the conversation:

• Click the down arrow next to your name at the top of the screen and select My Messages from the menu.
• Use the Message ID to find and open the message you just submitted.
• Use the Follow-up button to create a linked message. Attach and submit up to five more documents. Continue sending follow-up messages until all documents have been uploaded to the same Message ID.

Continue using the same Message ID to communicate with us until the issue is resolved. Starting a new conversation will just slow things down.

EmblemHealth: Try it Now

Connecticare: Try it Now