{"id":5340,"date":"2020-05-04T20:22:33","date_gmt":"2020-05-04T20:22:33","guid":{"rendered":"http:\/\/hnetalk.com\/provider\/?p=5340"},"modified":"2020-05-04T20:22:33","modified_gmt":"2020-05-04T20:22:33","slug":"request-for-claims-review-determination-time-frame-may-2020","status":"publish","type":"post","link":"http:\/\/hnetalk.com\/provider\/request-for-claims-review-determination-time-frame-may-2020\/","title":{"rendered":"Request for Claims Review Determination Time Frame &#8211; May 2020"},"content":{"rendered":"<p>As most know, every provider has a right to request a review of their claims payment if they disagree. Here at Health New England, we allow you to submit a request for review 12 months from the date of service or date of discharge for inpatient services. We do ask for a Request for Claim Review Form and supporting documentation to be mailed to Health New England at One Monarch Place, Suite 1500, Springfield, MA 01144. This form can be found at <a href=\"https:\/\/healthnewengland.org\/forms\" target=\"_blank\" rel=\"noopener\">https:\/\/healthnewengland.org\/forms<\/a> under the Providers tab.<\/p>\n<p>Although we do our best to turn these requests around quickly, to thoroughly research and make a determination, it takes approximately 90 business days. This is a change to the time frame we have historically done, but it will ensure the accuracy of our review and reduce the ask for a 2nd review. Please note, we will not take the full 90 business days, if it is not necessary.<\/p>\n<p>For more information on this process, please review the Request for Claim Review Guide on <a href=\"https:\/\/healthnewengland.org\/forms\" target=\"_blank\" rel=\"noopener\">https:\/\/healthnewengland.org\/forms<\/a> or call your Provider Relations rep at (800) 842-4464, ext. 5000. You may also email <a href=\"mailto:providerrelations@hne.com\" target=\"_blank\" rel=\"noopener\">providerrelations@hne.com<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>As most know, every provider has a right to request a review of their claims payment if they disagree. Here at Health New England, we allow you to submit a request for review 12 months from the date of service or date of discharge for inpatient services. We do ask for a Request for Claim [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":4875,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[92],"tags":[],"class_list":["post-5340","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-provider-newsletter"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/hnetalk.com\/provider\/wp-content\/uploads\/2019\/09\/ThinkstockPhotos-151016267-e1569599947573.jpg?fit=800%2C533","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p6ZZHB-1o8","_links":{"self":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/5340","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/comments?post=5340"}],"version-history":[{"count":1,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/5340\/revisions"}],"predecessor-version":[{"id":5342,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/5340\/revisions\/5342"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/media\/4875"}],"wp:attachment":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/media?parent=5340"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/categories?post=5340"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/tags?post=5340"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}