3/20/2023 0 Comments Ghi emblem health find a docxtor![]() ![]() Out-of-Network Providers Submitting Medicare Advantage Claimsįor claims denials that resulted in partial or zero payment: You are only permitted to file a standard appeal for a denied Medicare Advantage claim if you complete a Waiver of Liability, which states that you will not bill the member regardless of the outcome of the appeal. Completed forms can be faxed to (516) 394-5693. Please download the Claims Reconsideration Request Form and follow the instructions. Claim ReconsiderationĪs a participating HCP provider, you may request Claim Reconsideration for any claim submission that you feel was not properly processed. Login credentials for EZ-Net are required. Use EZ-Net, HCPs secure web-based data exchange application, to view the status of an existing claim previously submitted to HCP. Where HCP is the secondary payor under Coordination of Benefits, the time period shall commence once the primary payor has paid or denied the claim. The timely filing for Medicaid, Medicare, and Commercial claims is within 120 days of the date of service. Highlighted areas can become fully obscured during the scanning process. ![]() All paper documents are scanned using light-sensitive equipment.
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