UPDATE TO PREVIOUS COMMUNICATION FOR COMMERCIAL PLANS: Claim Redetermination Process Change
The claim redeterminations process on the Provider Portal for Commercial and BSWH Employee plans is changing. The new process is now the Provider Claim Review Request and will be available to providers via the Provider Service Center.
Benefits of the Provider Claim Review Request include detailed claim analysis, real-time adjustments on most claims and quick follow-up.
Effective Aug. 14, 2023, you may contact the Provider Service Center for Commercial and BSWH Employee claims for assistance, rather than submitting through the provider portal. New phone numbers will be provided to you prior to Aug. 14.
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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