Claims appeals process

If you believe a claim was denied in error or disagree with a payment determination, you may submit an appeal for further review. The claims appeals process allows providers to request reconsideration and provide additional information to support their request.

Timeframe

Must be submitted within 180 days of the Explanation of Provider Payment (EPP).

Submission process

Fax: 877-411-5964

Mail: 
Luminare Health Appeals Department 
PO Box 2905 
Clinton, IA 52733-2905

Necessary information

  • Member name and ID number
  • Claim number and date(s) of service
  • Reason for appeal
  • Supporting clinical documentation
  • Signed authorized representative form from the member

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