New Universal “Request for Claim Review Form”
Posted on June 29, 2011
In our ongoing effort for administrative simplification for Providers, we are pleased to share with you the form that will replace the current HNE Provider Appeal form, On Time Corrected Claim form and Coordination of Benefits form. The “Request for Claim Review” form has been approved by 7 health plans to help provider offices streamline their processes. Please begin using this form immediately. You can access the form on HNE.com. This form can be faxed to 413-233-2797 or mailed to One Monarch Place, Suite 1500, Springfield, MA 01144-1500.
The health plans that will be using this form are Blue Cross Blue Shield of Massachusetts, Fallon Community Health Plan, Harvard Pilgrim Health Care, Neighborhood Health Plan, Network Health, Tufts Health Plan and HNE.
