April 7, 2021 Provider Update

NextLevel Health Claims Operations Now Closed

As previously communicated, NextLevel Health ceased operations on June 30, 2020, and its Medicaid membership transitioned to Meridian Health effective July 1, 2020. NextLevel Health (NLH) is now in the final stages of closeout of its operations.

The NLH Provider Memo posted August 24, 2020 described NextLevel Health requirements for all providers to meet specific claim submission and reconsideration standards to facilitate payment. Timely filing guidelines allowed up to 180 days from the date of service to submit claims. Therefore, providers who provided services for former NLH members for dates of service through June 30, 2020 had until December 31, 2020 to submit claims with date of service June 30, 2020. In addition, all claims disputes must have evidence of timely dispute being filed, and disputes must have been filed within 90 calendar days from the date of notification or denial being issued.

Now that timely filing deadlines for new claims and claim disputes to be submitted has passed, NextLevel Health is no longer accepting any new claim submissions or claim dispute submissions.