Appealing a Senior Care Plus Claim
Provider Partners
Non-Contracted Providers Appealing a Senior Care Plus Claim
Non-contracted Providers Appealing a Senior Care Plus Claim
If you disagree with Hometown Health’s processing of your claim, you should submit a provider reconsideration within sixty (60) days from the explanation of payment.
When completing a request for reconsideration please indicate the specific reason that you want this claim reprocessed and attach all supporting documentation. The more complete the documentation, the more quickly the reconsideration can be processed. Please ensure a completed Waiver of Liability Statement is included. The Waiver of Liability Statement can be found here.
Hometown Health will respond within sixty (60) days of receipt of the reconsideration request with either an EOP or an explanation advising that the decision has been upheld and why.
Appeals for untimely filing should include confirmation that Hometown Health received and accepted your claim within the 365 days after the date of service or other supporting documentation if Hometown Health was not sent the claim because of presumed or confirmed other primary insurance coverage for the member.
You have two options to submit a reconsideration:
Reconsiderations may be submitted by fax to 775-982-3741. When faxing your request be sure to use the Provider Claim and Authorization Reconsideration Form and include medical records, if applicable.
Reconsiderations may be mailed. When mailing your request be sure to use the Provider Claim and Authorization Reconsideration Form and include medical records, if applicable.
