Decisions, Decisions: Help on How to Appeal a Decision

Date: 09/27/19

As a Coordinated Care member, you have the right to review decisions. We want you to understand decisions made about your healthcare.

When a claim or service is denied, you will receive a “Notice of Adverse Action (NAA).” The letter will explain the denial or limited authorization of a request. An appeal is a request for Coordinated Care to reconsider or change a decision that is on your NAA. An appeal may be filed to reconsider, for example, a denied claim or service. You or your authorized representative (with written consent from you) may appeal any adverse decision.

We have resources to guide you on how to make an appeal. Visit our Complaints and Appeals site to find out how to file an appeal.