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Web file a complaint or request an appeal online or by phone for your healthcare plan. Web learn how to appeal or dispute finalized humana medicare, medicaid or commercial claims online or by mail. Either you or your treating provider can file an appeal on your behalf. Web if you have a complaint or appeal related to your humana plan or any aspect of your care, we want to hear about it and see how we. At the end of this packet is a form. Please explain your grievance/appeal, or complaint and your expected resolution. Download the appeal form for medical. Web forms for providers to submit prescription drug exception and appeals, including coverage determination forms. Web submit appeal and dispute requests for finalized humana medicare, medicaid or commercial claims in a streamlined online. Web who can file an appeal? Web grievance and appeal request form. Please complete this form with information about the enrollee whose treatment is the. Web provider name date of service.