Claim Disputes After July 1, 2021

Providers electing to dispute the disposition or reimbursement level of a claim for Date of Service after July 1, 2021, may do so via the Meridian secure provider portal. Submitting a claim dispute is a simple process.

  • Select the claim and provide appropriate reason for the dispute.
  • Supporting documents can be attached, i.e. medical records, etc.
  • The dispute will be reviewed by a dispute analyst.
  • If your original claim reimbursement is updated, you will receive new reimbursement via the Explanation of Payment.
  • If your original claim reimbursement is upheld, a letter will be sent acknowledging the reason for dispute being upheld.

While the preferred method to submit a claim dispute is via the Meridian secure provider portal, you may submit a dispute via mail. Please include the claims dispute form (PDF). Disputes should be mailed to:

Meridian

Attn: Claims Department
PO Box 4020
Farmington, MO 63640

The following is intended to assist pharmacies when navigating within the CVS Caremark Pharmacy Portal in order to submit MAC Appeals.

MAC Appeals Form (PDF)