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Disputes & Appeals

Information to guide you

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The dispute process made simple

The dispute process allows you to disagree with a claim or utilization review decision.

Discover how and when to submit a dispute. Learn about the timeframe for appeals and reconsiderations. And find contact information for different issues.

Learn about the dispute process

Medicare Appeals

Medicare appeal process

Discover how and when to appeal payment decisions.

Understand the appeal process


Hospital discharge appeal process

Medicare patients can appeal a hospital discharge decision. This is called a Quality Improvement Organization (QIO) review.

Learn about discharge appeals

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Have more questions?

Read our FAQs. We have answers to many questions, including:

  • What is a dispute?
  • What is the procedure for disputing a claim decision?
  • What is a reconsideration?
  • What is a Level 1 appeal?


See FAQs

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State-specific information

We have state-specific information about disputes and appeals. We also have a list of state exceptions to our 180-day filing standard. Exceptions apply to members covered under fully insured plans.

State-specific forms about disputes and appeals
State exceptions to filing standard

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