FOR COMMERCIAL PLANS: Claim Appeal/Redetermination Process Change
Effective July 17, 2023, the process for submitting claim appeals/redeterminations for Commercial and BSWH Employee plans has changed. If you have a redetermination request or claim appeal, contact the Provider Service Center at 844-633-5325 for Commercial claims or 1.800.655.7947 for BSWH Employee Plan claims for assistance, rather than submitting through the provider portal. Please continue to use the IVR and the provider portal for benefits, eligibility and basic claims status.
There are no changes to the Medicare and Medicaid claim appeals and redeterminations process. For Medicare and Medicaid claim appeals and redeterminations, please maintain the current process of submitting through the provider portal or by mail.
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