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If you or your prescriber believe that waiting 7 days for a standard decision could seriously harm your life, health, or ability to regain maximum function, you can ask for an expedited. Web request for redetermination of medicare prescription drug denial (appeal) (pdf) this form may be sent to us by mail or fax: You may file an expedited (fast).
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You may file an appeal by sending us a letter or use the member appeal form provided in the link below. Request for reconsideration (level i) is a communication from the provider about a disagreement with the manner in which a claim was processed. Complete an appeal of coverage determination request and send it to: You may file an expedited.
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