Simpler Peer-to-Peer Process starts July 1, 2020

We’re improving our peer-to-peer process with a single phone line to help you work with us quickly and easily.

Effective July 1, you will have one phone number to call if you want to schedule a peer-to-peer conversation with a medical director for inpatient and outpatient services. The phone number is 616.464.8432. Additionally, we’ve expanded our hours of operations. You can contact us Monday—Friday, 8:30 a.m. – 4 p.m. There’s no change to the process for behavioral health services. Providers can continue to call 616.464.8500.

Historically, we had multiple phone lines depending on the type of service the provider was calling about. Our single, centralized line provides an easy scheduling solution.

The purpose of peer-to-peer discussion is to exchange information regarding the medical necessity of a denied prior authorization request. The call does not take the place of documentation required to support authorization.

You must schedule a peer-to-peer review within certain time frames, which vary depending on the authorization type.

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