Once you’ve tried all of your internal appeal rights with INTotal Health and we’ve continued to deny coverage or payment as stated in any final adverse benefit determination notice that you receive from us, you can request an external appeal with an independent review organization. The process is available for decisions about medical judgement including requirements for medical necessity, appropriateness, healthcare setting, level of care of effectiveness of a covered service, or our determination that the requested care or service is experimental or investigational.
An external review is independent from INTotal Health, and has the authority to overturn our denial coverage or payment. The external reviewer that is responsible for conducting your external appeal is the Department of Medical Assistance Services (DMAS).
To contact DMAS about an Independent External Appeal please call: 1.800.643.2273.
Every Time. Every Touch.
CALL 1.855.323.5588
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3190 Fairview Park Drive
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Our service promise is that we seek every opportunity to meet the unique needs of each person we are privileged to serve – every time, every touch.
