1. Appeals Process
• Providers have 30 days from the day the EOB was issued to appeal the denial ▫ Any appeal received over 30 days will not be considered
• To appeal a denied claim please follow the process outlined below: ▫ Complete the Reconsideration/Appeals Request form and send to Cathy Parente.
Must include justification as to why you feel the claim should not have been denied (e.g., auth was increased after claim was denied)
▫ ABH will render a written appeal within 15 days of receipt of appeal form.
▫If a denial is upheld, a second level appeal may be made to DMHAS. This decision is final.

2. Claim corrections/adjustments
• To correct a claim, please use the appeals form and send to Cathy Parente ▫ Clearly state what correction needs to be made (e.g., Claim # should be…) • Claims denied for the following reasons can be resubmitted by the provider and do not need to be appealed. ▫ Invalid diagnosis ▫ Incorrect or future date of service (e.g., 1/1/2051)