Claims Info and Providers Disputes

Submitting a Claim

Provider Dispute

A provider dispute is a written notice from a provider that challenges, appeals, or requests consideration in any of the following categories:

  • Claim

  • Billing Determination

  • Appeal of Medical Necessity

  • Utilization Management Decision

  • Request for Reimbursement of Overpayment

  • Contract Dispute

  • Other Categories Not Listed

To file a Provider Dispute with Devoted Health Plan , please fax (1-877-358-0711) or mail ( Devoted Health – Appeals & Grievances, PO Box 21327 Eagan, MN 55121) a written dispute that include the following information:

  • Name and address

  • Devoted Health Member ID (on Member’s Health card)

  • Medicare number (on Member’s Medicare card)

  • Brief reason for the dispute – type of treatment or service member is seeking, date of intended service, and the reason for the dispute.

For more detail information about filing dispute with Devoted Health Plan, please click here (https://www.devoted.com/plan-documents/medical-coverage-rights/)


 

The compensation provided by HHMG to its providers, employees, or individuals performing utilization review on its behalf is devoid of any incentives, whether direct or indirect, that may influence the approval or denial of payment for healthcare services. The decision-making process regarding utilization is solely guided by the individual's clinical requirements, benefit availability, medical appropriateness of care and services, and the presence of coverage. Upon joining HHMG, all clinical reviewers affirm their adherence to this principle.