If you choose to mail or fax your request, you can either print the online form, or you can provide the following information in a letter: Member’s signature if the person filing the appeal is not the Member A brief description of the reason you disagree with your plan’s initial decision.
A member of SSM Health. All rights reserved. Secure Access. If you need assistance accessing information or documents on the Dean Health Plan website and require the information be provided in an alternate format, please contact our call center at 1-800-279-1301 (TTY: 711).
A brief description of the reason you disagree with your plan’s initial decision. Documents to support the claim, such as letter’s from your Health Care Provider, reports, bills, medical records, explanation of benefits (EOB) forms (optional) Letters sent to your health insurance plan about the denied claim (optional)
To file a grievance, you or your authorized representative must send your grievance to us in writing at the following address: Dean Health Plan, Inc. Attention: Grievance and Appeal Department P.O. Box 56099