MedStar Family Choice will accept appeals in writing within applicable time frames. Providers acting on their own behalf are defined as those who dispute Adverse Actions when the service has already been provided to the member and there is no member financial liability. A provider appeal must include a clearly expressed desire for re-evaluation/appeal, with an indication as to why the Adverse Action was believed to have been issued incorrectly that MedStar Family Choice is able to investigate. 

Claims Appeals

Additional information is available on the Claims Appeals Procedures website

Clinical Appeals

Additional information is available on the Clinical Appeals Procedures website

Information current as of: 10/29/18