Provider Remittance Advices
We are aware of provider remittance advices not populating into your portal. We are actively working on getting this resolved.
1 nov, 2019

New appeals & claims adjustment forms

Our Grievance and Appeals Unit (GAU) has been working hard to update the appeals request form and the claims adjustment form. The new forms can be found on under provider forms. You can also click the links below to be redirected to the forms. Please ensure your office is utilizing the new forms effective immediately.

Appeals Request Form

Claim Adjustment Form

As a reminder, claim adjustments are not to be sent to GAU, and should be mailed to the claims department to the address on the bottom of the claims adjustment request form.

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