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Claims Reconsiderations __________________________________________________________
All reconsiderations must be submitted within 90 days from the date of explanation of payment unless otherwise outlined in the provider agreement . Provider ’ s failure to submit requests within such time period and according to the processes outline below will result in the request being denied by Hometown Health .
If an underpayment is identified on a large volume of claims and an adjustment is needed please fill out the Large Volume Underpayment Adjustment Request Form located at
https :// www . hometownhealth . com / provider-forms / or in Link in order to request the adjustment . The form can be submitted in the following fashions :
Email - HTHProviderRelations @ hometownhealth . com Fax – 775-982-8003
* An email inquiry is not considered a formal request for adjustment .
If you believe that Hometown Health has not processed your claim correctly for any reason including timely filing or denial for needed medical records , you should submit a provider reconsideration . For the fastest response to your reconsideration , please use Link and complete a Customer Relationship Management ( CRM ) request . . You will be assigned a CRM number for each reconsideration . All supporting documentation can be uploaded into the CRM . If unable to submit additional information to the CRM , you may fax it to 775-982- 3741 . If faxing supporting documentation , please clearly list the CRM number on the fax cover page . This will enable us to match up your documentation with the correct reconsideration .
Although the quickest turn around for reconsiderations is through Link , as a last resort reconsiderations may also be submitted by fax to 775-982-3741 or mailed . When faxing your request be sure to use the Hometown Health Reconsideration Request Form located on
www . hometownhealth . com and include medical records , if applicable .
Finally , reconsiderations may also be mailed to :
Hometown Health Attn : Provider Reconsiderations 10315 Professional Circle Reno , NV 89521
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