Provider Appeals
Posted on March 30, 2021
At Health New England, providers have the right to file an appeal if they disagree with how we processed a claim. If you choose to have a claim payment reviewed, you must do so within 12 months from the date of services or date of discharge for inpatient services. We also ask that you reference the guidance in our Provider Manual to ensure you include the required documentation. The manual is located at healthnewengland.org/providers/provider-manual/appeals.
With each request, we do acknowledge receipt within 45 days, and provide in writing a determination within 90 business days. If you haven’t heard from us within the first 45-day timeframe, please call Provider Relations at 800-842-4464, extension 5000, or send an email to providerrelations@hne.com.
