• Provider Portal Enhancement: New Appeals Submission Tool

  • Affinity Health Plan will now be accepting medical necessity appeals on our provider portal. This enhancement comes at a time when there is a critical need for providers to be able to remotely submit and view appeals and appeal status online rather than having to mail in their requests.

    Some benefits of submitting appeals online include:

    • Provider can submit medical necessity appeals and upload medical records and supporting documents anytime online.
    • Providers can select appeal urgency and type.
    • The overall turnaround request time may be reduced by eliminating mail delay.
    • Provider will receive immediate confirmation of receipt and an email with an appeal reference number.
    • Provider will be able to view the appeal status online.

    This new tool can be found on the provider portal home page under the authorizations tab.

    To submit a medical necessity appeal online, providers need to enter the authorization number and member ID, and then follow the instructions to complete the request. Providers can view the status of an appeal submitted electronically or manually (by mail) by entering the appeal number at any time.