![]() Health Net does not request that providers resubmit claim information or supporting documentation that was previously submitted to Health Net as part of the claims adjudication process unless Health Net returned the information to the provider. The provider must resubmit an amended dispute along with the missing information within the time frame for dispute submissions and the amended dispute must include the information requested and required to make the dispute complete. If the provider dispute does not include the required submission elements as outlined above, the dispute is returned to the provider along with a written statement requesting the missing information necessary to resolve the dispute. If the provider dispute involves a member, the dispute must include the member's name, ID number, a clear explanation of the disputed item, the date of service, billed and paid amounts, and the provider's position.Īll provider disputes and supporting information must be submitted to: Line of Business When a provider submits a dispute on behalf of a member, the provider is considered to be assisting the member with his or her member appeal.
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