Claims

Claim Denials

If a claim is denied, in whole or in part, you will receive written notice of the denial and the reasons for the denial. The notice will also inform you of the right to file a grievance and the procedure to follow. Pre-service authorization denials will be considered claim denials and will follow the same notification process.

If you have a complaint or want to file a grievance regarding a claim denial, please contact Members Services at 1-888-711-1444.