June 3, 2021
To help make it easier for you to submit appeals for our Medicare Advantage members, we’ve created a new easy to follow, fillable, appeal form. You can use this form to submit your level I and level II appeals as well as pre-service denials and payment
appeals.
You can find the new
appeal and reconsideration form linked on our Medicare Advantage forms page. You can also find all Medicare Advantage forms on the secure section of the website by selecting the Resources tab and
then Forms.
If you have questions about submitted appeals, call customer service at 888-850-8526.