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Select Claims from the left-hand navigation menu. Select Appeal Claim from the left-hand navigation menu, and then Go to Availity. If you are navigating to the claims submission tool from .Availity.com: Click on Log in and enter your Availity ID and password.
How to request an appeal. You must submit your appeal within 60 days of the date on our first denial letter.
To be considered for appeal review by HHSC Medical and UR Appeals, a complete written appeal request, with all required documentation included, must be received by the Medical and UR Appeals Unit within 120 days of the date of the Notice of Adverse Determination indicating that the decision may be appealed to HHSC ...
Written complaints can also be sent to the attention of the Provider Relations department of the local health plan or faxed to 1-844-664-7179. Complaints may also be sent by email to TXproviderrelations@amerigroup.com or via the provider website at .
Recreate the Claim In the Availity Essentials menu bar, select Claims & Payments, and then select either Professional Claim or Facility Claim under Claims, depending on which type of claim you want to correct.