As per BCBS Highmark- there was a system error that was identified, on EOPs, for the following Plans: CHP, MCD, EP, HARP.

If you are a NY provider that accepts above mentioned plan types in your office/facility, then this blog post ia for you!

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What was discovered?

• The language in the EOPs erroneously directed the providers to submit external appeals to the Wisconsin Medicaid appeals address.

The issue has been resolved.

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Affected EOPs- DOS range:

• 3/15/2026 to 6/10/2026

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The correct process for Medical appeals

• Time frame- within 60 calendar days from the date of notice
• The case needs to be in denied status to qualify for the appeal process
• Use Availity – Availity Essentials multi-payer Authorization and Referral application – you will need to have Authorization Referral Request role assignment in Availity Essentials.
• Physical Standard Snail Mail: Medical Appeals
  P.O. Box 62429
  Virginia Beach, VA 23466
• Fax – for expedited appeals: 1-844-759-5954

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The providers in Wisconsin should be the only ones to submit the i formation to the Wisconsin Medicaid appeal address.

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Find this type of contact useful? Follow my blog for more!

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