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Claims Appeals Procedures

All claims appeals must be submitted in writing within 90 business days from the date of the explanation of benefits. Attach supporting documentation, such as clinical documentation, copies of the claim, EOB, and explanation for appeal (including why the provider believes the claim was denied incorrectly), and mail this information to the following address:

MedStar Family Choice
5233 King Avenue, Suite 400
Baltimore, MD 21237

We will send an acknowledgement letter that we have received your appeal within 5 business days. You will receive a response regarding your appeal within 30 calendar days of receipt of all necessary information.

Second level appeals must be sent in writing to the address above within 30 calendar days from MedStar Family Choice's response letter. We will send an acknowledgement letter that we have received your appeal within 5 business days. You will receive a response letter regarding your appeal within 30 calendar days of receipt of the appeal.

If the claims denial is overturned, you will receive payment within 30 calendar days of the decision.

For a status on a claims appeal, please call our Claims Department at (800) 261-3371.

Tips:

  • Do not send in late appeals as they will not be considered.
  • Providers with corrected claims should send these to our claims address for processing; appeals are for claims denied as originally submitted.
Information current as of: 12/14/17