Provider Dispute Resolution

MHN has established a provider dispute resolution process for both individual practitioners and facility providers, that provides consistent, timely, and effective de novo review of an issue that has not been satisfactorily resolved through our regular provider customer service channels. This process is available to both contracted and non-contracted providers.

The first steps towards resolving a dispute are outlined below.
NOTE: The majority of issues with authorizations, claims can be resolved through Customer Service or the Service Team.

  1. If you have a concern involving a claims payment issue, please call our Customer Service Department at (800) 444-4281.
  2. If you have a concern regarding authorizations and/or wish to access care for a member, please call the MHN Service Team to obtain the member's employer group. This number is referenced in your authorization letter and/or should be listed on the back of the member's medical insurance ID card.
  3. If you have a concern that involves a contracting status, please contact Professional Relations at
  4. For cases where authorization has been denied because the case does not meet medical necessity criteria, please follow the dispute resolution process below.
  5. If you suspect fraud or abuse in the provision of services or submission of claims, please contact our Fraud & Abuse Hotline at (800) 327-0566.