PHP will research all claim payment disputes and provide a response within 30 days of receipt. Claim payment disputes may be submitted in writing by mail or fax:Īppeals must be received within 90 days from the date of adverse determination and/or date the claim was processed.
PHP has processes for documenting and responding to administrative complaints, including claim payment decisions. PHP may review and adjust these reimbursement schedules on a yearly or as market determines basis. In keeping with the Centers for Medicare and Medicaid (CMS) reimbursement methodologies for the mid-Michigan region, PHP's Non-Network standard reimbursement schedules are a reasonable and customary charges standard. Non-network providers are reimbursed in accordance with network leased pricing, as applicable, or per PHP's Non-Network standard reimbursement schedules. Payor Name: PHP Non-Network Provider Reimbursements Payor Name: PHP Non-network providers may submit claims to: Claims Network providers may submit claims to: If you need further information, please visit the Contact Us page for assistance. The forms and information available here will help you file claims to the appropriate addresses and facilitate your reimbursements.
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