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Geisinger Health PlanAll Plans · Administrative · ClaimsMedium impact

Are you using the Claim Research Request Form correctly?

Effective date
Not stated in the notice
Identified
Oct 23, 2026

Summary

Geisinger Health Plan issued guidance on proper use of the Claim Research Request Form (CRRF) for claim reconsiderations. The policy clarifies when a CRRF is appropriate (authorization denials with compelling reasons, claim edit denials, timely filing denials with justification, and corrected claims outside filing limits) versus when it should not be used (replacement/voided claims, corrected claims within filing limits, authorization denials without compelling reason). All CRRFs must include supporting documentation and be submitted within 60 days of the EOP date, or the original denial will be upheld.

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What to do

Action · 9 steps
01Billing team should review and implement the CRRF submission guidelines to ensure compliance with Geisinger Health Plan requirements.
02Use the Claims Appeals function in Availity whenever possible instead of paper CRRF forms.
03Submit only complete CRRFs with all required supporting documentation within 60 days of the EOP date—incomplete submissions or those after 60 days will result in original denials being upheld.
04Do not submit CRRFs for replacement claims, voided claims, corrected claims still within timely filing limits, or authorization denials lacking compelling reasons, as these create unnecessary delays.
05Include claim number, date of service, appropriate reconsideration reason, and submitter contact information on all CRRFs.
06For timely filing reconsiderations, include proof of timely filing.
07Do not submit duplicate reconsideration requests.
08Processing time is up to 45 days upon receipt of a complete CRRF.
09Verify current applicability and update billing workflows to align with these best practices.

Original notice

Are you using the Claim Research Request Form correctly?
geisinger.org · Always check the source before changing claims.
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