Find appeal teams, faxes and mailing addresses. Use the denial notice to confirm the appeal level, filing deadline and recipient.
fax appeals
Provider inquiry and appeal form fax
Official page read
Phone
No phone listed for this route
Fax
855-260-4527
Published hours
Not published in this record
Product, plan and location
commercial Oregon · Alaska · Texas
Mailing addressModa Health Plan, Inc.
Provider Appeal Unit
P.O. Box 40384
Portland, OR 97240
Provider inquiries and appeals.
Mail or fax the Moda Provider Inquiry and Appeal Form with supporting documentation. Non-contracted providers have 180 calendar days from the remittance date to request reconsideration; contracted providers follow their contract.
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Find appeal teams, faxes and mailing addresses. Use the denial notice to confirm the appeal level, filing deadline and recipient.
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Denial notice, remittance and reason codes
Previous appeal confirmation and decision
Supporting evidence and any required authorization to represent the member
Questions to resolve
Is this a claim correction, provider dispute or member appeal?
What deadline and submission channel apply to this case?
How can the office confirm receipt and track the decision?
This is a general administrative checklist, not payer policy or advice about a particular patient. Confirm the current plan instructions.
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