UPDATE TO MERIDIAN ADVERSE DETERMINATION APPEAL PROCESS

Date: 03/29/22

Please note this additional clarification regarding the recent adverse determination notice. To assist our providers, we have enhanced our determination process alleviating an unnecessary administrative step, and aligned the authorization process for our lines of business. This update removed a redundant reconsideration step from the Medicaid physical health utilization management process.

The original purpose of reconsideration was to make providers aware of approval criteria. Per HB 711, InterQual Connect™ criteria are available through our secure provider portal. 

All providers can still utilize the peer-to-peer option by calling 833-541-2297.

A claim dispute may be submitted by mail to the address below. 

 

        Meridian of Illinois

        PO Box 4020

        Farmington, MO 63640-4402