If you are already getting services, you may be able to keep getting services during your appeal or hearing. To keep getting services, all of these things must be true:
- You file the appeal within sixty (60) calendar days of the date on the letter from First Medical.
- You ask to keep getting services by the date your care will stop or change or within ten (10) calendar days of the date on the letter from First Medical (whichever date is later).
- You say in your appeal that you want to keep getting services during the appeal.
- The appeal is for the kind and amount of care you’ve been getting that has been stopped or changed.
- You have a doctor’s order for the services (if one is needed).
- The services are something that Vital still covers.
If you keep getting services during your appeal or Administrative Law Hearing and you lose, you might have to pay First Medical back for the services you got during the appeal or Administrative Law Hearing process.
To continue getting services during your appeal or Administrative Law Hearing, call First Medical at 1-844-347-7800; TTY/TDD users should call 1-844-347-7805.