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Medicaid Managed CareIndependent Review Provider Reconsideration Form Return completed form by mail or email to: Healthy Blue Attn: Independent Review 3850 N. Causeway Blvd., Suite 1770 Metairie,
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What is independent review provider reconsideration?
Independent review provider reconsideration is a process where a review organization re-evaluates a previous decision regarding healthcare services or claims based on new information or arguments presented.
Who is required to file independent review provider reconsideration?
Healthcare providers, patients, or authorized representatives who disagree with a previous review decision regarding a claim or service are required to file for independent review provider reconsideration.
How to fill out independent review provider reconsideration?
To fill out an independent review provider reconsideration, one should complete the designated application form, include all relevant documentation such as previous decisions, medical records, and any additional evidence supporting the case.
What is the purpose of independent review provider reconsideration?
The purpose of independent review provider reconsideration is to ensure that decisions regarding healthcare services are fair and based on a comprehensive review of all pertinent information.
What information must be reported on independent review provider reconsideration?
The information that must be reported includes the patient's details, a summary of the previous decision, reasons for reconsideration, all supporting evidence, and any relevant timelines.
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