If you disagree with claim payment issues, overpayment recoveries, pharmacy, medical management disputes, contractual issues or the outcome of your reconsideration review, send a letter requesting a review to:
Oxford Level Funded members:
P.O. Box 31393
Salt Lake City, UT 84131-0371
Standard Fax: 1-801-478-5463
You must submit your claim reconsideration and/or appeal to us within 12 months (or as required by law or your Agreement), from the date of the original EOB or denial. The two-step process allows for a total of 12 months for timely submission, not 12 months for step one and 12 months for step two.
As the care provider of service, you submit the dispute with the following information:
Refer to Claim Reconsideration and Appeals Process section in Chapter 10: Our Claims Process, for more information.