Selecthealth Appeal Form

We must get your appeal within 60 calendar days. First choice providers can use the following forms for credentialing and helping select health of south carolina members. Access the forms you need for appeals, information changes, access requests, preauthorization requests, electronic claims payment, and more. Most forms can be completed online,. What is the reason for the appeal?

What would you like us to do? How would you like us to contact you about this appeal? If you feel you’ve been treated unfairly,. Use this form for complaints about benefit coverage or a denied claim if you have questions, call our appeals and grievances department at the number above weekdays, from 8:00 a. m.