NextLevel Health’s contract for furnishing Health Services with the Department of Healthcare and Family Services terminated June 30, 2020 @ 11:59 p.m.Provider Memo
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. As previously communicated (see NLH Provider Memo posted August 24, 2020), NextLevel Health requires all providers to meet specific claim submission and reconsideration standards to facilitate payment. Timely filing guidelines allow 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. Now that the timely filing deadline has passed, any new claim submissions received January 1, 2021 or after will be denied.
If a provider disagrees with the claim adjudication outcome, a claim dispute must be filed. Please see the Claim Dispute Process Guidelines listed below that must be followed: Effective January 30, 2021 all claim disputes must be filed via emailing [email protected]. All claim disputes must abide by the following requirements to qualify for reconsideration:
Please email [email protected] with any questions regarding the status of your claims or claim disputes.