{"id":2515,"date":"2023-06-27T00:23:54","date_gmt":"2023-06-27T00:23:54","guid":{"rendered":"https:\/\/samhealth.org\/samhealthplans\/?page_id=2515"},"modified":"2023-08-21T21:03:37","modified_gmt":"2023-08-21T21:03:37","slug":"apelaciones-no-contratadas","status":"publish","type":"page","link":"https:\/\/samhealthplans.org\/es\/providers\/care-management\/authorizations\/non-contracted-appeals\/","title":{"rendered":"\u00a0Apelaciones no contratadas"},"content":{"rendered":"<section id=\"block_b3e17aacd9d1e39cc242c088accfca23\" class=\"shs-block block-section grid-container has-white-background-color\" >\n\t\t<div class=\"entry-content\">\n\n<h1 class=\"wp-block-heading\" id=\"h-appeals-for-non-contracted-providers\">Apelaciones para proveedores no contratados<\/h1>\n\n<\/div>\n\t<\/section>\n\n\n\n<section id=\"block_b3e17aacd9d1e39cc242c088accfca23\" class=\"shs-block block-section grid-container has-white-background-color\" >\n\t\t<div class=\"entry-content\">\n\n<p>Los proveedores no contratados siguen el siguiente proceso para apelaciones a Samaritan Advantage Health Plan:&nbsp;<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Los proveedores no contratados tienen derecho a solicitar una reconsideraci\u00f3n de la denegaci\u00f3n de pago del plan.<\/li>\n\n\n\n<li>Los proveedores no contratados tienen 60 d\u00edas naturales a partir de la fecha de notificaci\u00f3n de remesa para presentar la reconsideraci\u00f3n.<\/li>\n\n\n\n<li>Los proveedores no contratados deben incluir la&nbsp;<a href=\"https:\/\/samhealthplans.org\/es\/formulario-de-solicitud-de-apelacion-ventaja\/?type=pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Solicitud de apelaci\u00f3n para Samaritan Advantage<\/a>&nbsp;y firmado&nbsp;<a href=\"https:\/\/samhealthplans.org\/es\/declaracion-de-exencion-de-responsabilidad\/?type=pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Formulario de exenci\u00f3n de responsabilidad<\/a>&nbsp;manteniendo al inscrito indemne independientemente del resultado de la apelaci\u00f3n.<\/li>\n\n\n\n<li>Los proveedores no contratados deben incluir documentaci\u00f3n como una copia del reclamo original, una notificaci\u00f3n de remesa que muestre la denegaci\u00f3n y cualquier registro cl\u00ednico y otra documentaci\u00f3n que respalde el argumento del proveedor para el reembolso.<\/li>\n\n\n\n<li>Los proveedores no contratados deben enviar por correo la reconsideraci\u00f3n al plan a: Samaritan Advantage Health Plan, PO Box 1510, Corvallis, OR 97339<\/li>\n<\/ul>\n\n<\/div>\n\t<\/section>","protected":false},"excerpt":{"rendered":"<p>Comprenda el proceso de apelaciones para proveedores no contratados que trabajan con Samaritan Health Plans. <\/p>","protected":false},"author":20,"featured_media":0,"parent":2511,"menu_order":1,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"_searchwp_excluded":"","_shs_workflow_notes":"Updated URL to match current site URL.","_shs_exclude_from_navigation":true,"_shs_promote_article_on_blogs":"","footnotes":""},"class_list":["post-2515","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/samhealthplans.org\/es\/wp-json\/wp\/v2\/pages\/2515","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/samhealthplans.org\/es\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/samhealthplans.org\/es\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/samhealthplans.org\/es\/wp-json\/wp\/v2\/users\/20"}],"replies":[{"embeddable":true,"href":"https:\/\/samhealthplans.org\/es\/wp-json\/wp\/v2\/comments?post=2515"}],"version-history":[{"count":0,"href":"https:\/\/samhealthplans.org\/es\/wp-json\/wp\/v2\/pages\/2515\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/samhealthplans.org\/es\/wp-json\/wp\/v2\/pages\/2511"}],"wp:attachment":[{"href":"https:\/\/samhealthplans.org\/es\/wp-json\/wp\/v2\/media?parent=2515"}],"curies":[{"name":"Gracias","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}