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Claims Escalation

Claims Escalation Research & Resolution Process

Buckeye has excellent customer service through our Provider Services department who are dedicated to answering your questions and resolving issues. They are your first stop in a quest for information. See Provider Home page for phone #'s.

Effective October 1, 2021, when a Provider Services representative is unable to answer or resolve your claims questions, they will provide you with a service reference number to place on our Claims Escalation Form. The form will connect you to an Internal Provider Relations Representative who will review your submission.

Submission process:

  1. Complete our Claims Escalation Form (attached below) and send it to Buckeye via email to:
        Medical Claim issues
        Behavioral Health issues
  2. Please submit one form for each claim/incident you want reviewed.
  3. Within 3-5 business days, you will receive notification we have received your submission.

Review Process:

  1. Please allow up to 30 days from the date of notification for your submission to be researched.
  2. Within 30 days, you will receive an email response from your Internal Provider Representative with one of the following:
        a. Resolution to your submission and what to expect.
        b. Notification that your submission is being reviewed by our internal operations team and the details
        around the next steps being taken to resolve the issue. You will receive a reference number for this
        portion of the review process.
  3. In the event you don’t receive a response within the time provided in the notification, please reply to the notification email to follow up. Please be sure to include your reference number.
  4. Your Internal Provider Relations Representative will continue to communicate with you through this email address until the issue is resolved.

Claims Escalation Research and Resolution Form (PDF)