New Claims System Update

Provider Manual
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16 INTEGRANET COMPLAINTS, APPEALS, GRIEVANCES AND DISPUTES

16.3 IntegraNet Nonparticipating Provider Payment Disputes

Nonparticipating Provider Payment Disputes
If, after a claim has been adjudicated, a nonparticipating provider contends that our decision to pay for a different service from the one originally billed or believe they would have received a different payment under Original Medicare, the nonparticipating provider payment dispute resolution process can be used. Notification will be provided to the nonparticipating provider at each step of the process.