December 19, 2019
Evolent Health (Evolent) is managing all level one appeals and peer-to-peer reviews for LifeWise 2020 Individual health plan members. LifeWise will handle level two appeals. To submit a clinical appeal on behalf of a patient (denied prior authorization), do one of the following:
- Submit an appeal form by fax to 844-990-0262. The new form will be on the provider secure website and the LifeWise non-secure website under “Forms” starting 1/1/2020.
- Call customer service at 800-817-3056 to start an appeal process.
To submit an appeal on a claim:
- Call customer service at 800-817-3056 and they’ll provide you with instructions on how to submit an appeal letter.
- To request a peer-to-peer review, call customer service at 800-817-3056 and they can direct you on how to speak with an Evolent medical director.