|
Provider Reconsiderations
Effective 5/1/2025: Any provider request for reconsideration of a denial, which
could include submission of a new PA request will be handled in a manner
consistent with the member appeal process.
Providers may submit an appeal on behalf of a member with written member consent. To request a member appeal you must use the Member Appeal Request Form/Request to Review a Health Care Decision (OHP Form 3302).
Submitting an Appeal on Behalf of a Member
The member appeal form is located here
· OHP 3302 Appeal and Hearing Request
Member appeals must be submitted within 60 days from the date of the denial. Providers must have written authorization from the member to appeal on their behalf.
You can mail, fax or email your appeal:
Fax: 503-765-9675
Email: appeals@yamhillcco.org
Mail: Yamhill Community Care
Attn: Appeals & Grievance Specialist
PO Box 5490
Salem, OR 97304
Phone: 971.345.5933, please use the provider prompt
Members have the right to appeal denials and receive a form (OHP 3302) included with the YCCO denial letter. Member appeals must be submitted within 60 days from the date of their NOABD (denial letter). The member, their representative, or provider with member’s written consent may file an appeal orally or in writing. More information on the member appeal process can be found in the Provider handbook or Member handbook.
More info can be found on the YCCO website here https://yamhillcco.org/for-providers/billing/denial-and-claim-guidance/
| 
