Notes

Called PASSPORT HEALTH PLAN (ID 1070) (800)578-0775 S/w Stephen asked rep about claim status and he stated that claim is not on file ,policy Effective from 01/01/2021 active on dos so need to resubmit claim on verified mailing address,TFL 1 years from dos ref#Sfa29865994
8665150596


policy effective date active sine jan 1 2021 tfl 1 years from dos name-stephen no. Sfa29865994

f81801s do not cover secondary denied diagnos code is used never listed as primary diagnoseds prosceduors appeal mailling address po box 36030 lousville ky 40233 Fax number- 8663152572 tfl 60 days from last process date make sure your attached prvde appeal form located on molinahealthcare.com, ref#sfa29858373 //NAME mia


REC ON 07/31/23, PROC 08/01/23 DENIAL contract REQ doucmentation incorrect invoice corrected claim and atached the invoice , Fax number electronically or mailpo box 36090 louisville, ky 40233. claim number: 23206180626// name miaG #sfa29856156//NAME MIA



Called PASSPORT HEALTH PLAN (ID 1070) (800)578-0775 S/w Mia asked rep about claim status and she checked the claim status and stated that the claim received on 07/31/23 ad denial on 08/01/2023, claim denial due to incorrect invoice so need to submit documents and attach with correct invoice electronically or mailing address PO BOX 36090 Louisville, Kentucky 40233. ref#sfa29856156