{"id":7749,"date":"2022-09-28T16:38:22","date_gmt":"2022-09-28T16:38:22","guid":{"rendered":"http:\/\/hnetalk.com\/provider\/?p=7749"},"modified":"2022-09-28T16:38:22","modified_gmt":"2022-09-28T16:38:22","slug":"request-for-claim-10-22","status":"publish","type":"post","link":"http:\/\/hnetalk.com\/provider\/request-for-claim-10-22\/","title":{"rendered":"Request for Claim Review Policy and Procedures: Post Payment Disputes"},"content":{"rendered":"<p>Health New England is committed to reviewing our internal procedures and define how we reconsider payment decisions with applicable laws and industry standards. We have recently reviewed our Provider Manual and will be releasing additional policies and procedures to help you determine when to submit a corrected claim vs. an appeal with a payment dispute. In addition, these documents will help you understand certain requirements prior to rendering the services to ensure there are no disruptions with your payment.<\/p>\n<p>Effective November 1, 2022, you will have access to the following policies and procedures by visiting <a href=\"http:\/\/healthnewengland.org\/Providers\/Resources\" target=\"_blank\" rel=\"noopener\">healthnewengland.org\/Providers\/Resources<\/a>.<\/p>\n<ul>\n<li>Notice of Prior Authorization Denials<\/li>\n<li>Filing Limit Denials<\/li>\n<li>Contract Rate Payment Policy and Clinical Policy Denials<\/li>\n<li>Duplicate Denials<\/li>\n<li>Request for Additional Information Denials<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>For additional questions, please call your Provider Relations Representative at (800) 842-4464, extension 5000, or send an email to <a href=\"mailto:providerrelations@hne.com\" target=\"_blank\" rel=\"noopener\">providerrelations@hne.com<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Health New England is committed to reviewing our internal procedures and define how we reconsider payment decisions with applicable laws and industry standards. We have recently reviewed our Provider Manual and will be releasing additional policies and procedures to help you determine when to submit a corrected claim vs. an appeal with a payment dispute. [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"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-7749","post","type-post","status-publish","format-standard","hentry","category-provider-newsletter"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p6ZZHB-20Z","_links":{"self":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/7749","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=7749"}],"version-history":[{"count":3,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/7749\/revisions"}],"predecessor-version":[{"id":7752,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/7749\/revisions\/7752"}],"wp:attachment":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/media?parent=7749"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/categories?post=7749"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/tags?post=7749"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}