HIPAA training

Louisiana Healthcare Connections Claims Appeal

In order to file an appeal the provider must have received an unsatisfactory response to a request for reconsideration. Submit the following items when filing an appeal:

  • Claim Appeal Form (www.LouisianaHealthConnect.com)
  • Original Request for Reconsideration letter and response
  • Any supporting documentation supporting the request for an appeal

The medical records will not go to the MRU if: there is no claim form attached; there is no original claim number listed on the corrected claim form; there is no reconsideration form attached; and the original claim did not deny asking for medical records.

  • Mail your Claim Appeal Form and all other attachments to: Louisiana Healthcare Connections Attn: Claim Appeal PO Box 4040 Farmington, MO 63640‐3826 If a provider’s submission of a corrected claim, request for reconsideration or claim appeal results in an adjusted claim, the provider will receive a revised EOP.

If the original decision is upheld, the provider will receive a revised EOP or letter detailing the decision and steps for escalated reconsideration. Louisiana Healthcare Connections shall process and finalize all corrected claims, requests for reconsideration and appeals to an “upheld,” “approved,” “paid” or “denied” status within 30 calendar days of receipt of the corrected claim, request for reconsideration or claim appeals.

To learn more about EDI and become a certified EDI Professional, please visit our course schedule page.

Leave a Reply

Your email address will not be published.

Post Navigation