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State of CaliforniaHealth and Human Services AgencyDepartment of Health Care ServicesWILL LIGHTHOUSE DIRECTORPROVIDER NAME ADDRESS 1 ADDRESS 2 CITY, STATE GAVIN NEWSOM GOVERNOR May 28, 2021, NPI #
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Identify the reason for the denial of the submission.
02
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Who needs 31127p42719resubmission of erroneously denied?
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Individuals or organizations who have had their initial submission erroneously denied and wish to resubmit for reconsideration.
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What is 31127p42719resubmission of erroneously denied?
31127p42719resubmission of erroneously denied is a process to correct a denial that was made in error.
Who is required to file 31127p42719resubmission of erroneously denied?
Individuals or organizations who have received an erroneous denial must file the resubmission.
How to fill out 31127p42719resubmission of erroneously denied?
To fill out the resubmission, one must provide the correct information that proves the denial was made in error.
What is the purpose of 31127p42719resubmission of erroneously denied?
The purpose of the resubmission is to correct the error and have the denial overturned.
What information must be reported on 31127p42719resubmission of erroneously denied?
The resubmission must include evidence or documentation that supports the claim that the denial was made in error.
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