Claims Issue? Resolve it Using the New Claim Concerns Intake Form
Date: 09/09/25
Providers can use the new Claim Concerns form to submit unresolved claims issues directly to the right team.
The Claim Concerns form is designed to simplify and improve the resolution of outstanding claim issues. It offers a convenient entry point that automatically routes submissions to the team best equipped to review and resolve claim issues. The form will capture all the necessary information upfront to streamline the process, reduce delays and ensure your claim issues are handled efficiently and quickly resolved.
This enhancement is part of Sunshine Health’s continuing efforts to improve the provider experience. We’re moving away from shared mailboxes and individual emails to give providers more reliable web-based submission tools that allow us to better track, consolidate and address provider concerns while ensuring each inquiry quickly reaches the appropriate team.
Sunshine Health Provider Tools
We encourage providers to use our web tools to submit your requests for faster, more effective results:
- Become a Provider: Join our network.
- Claim Concerns: Submit claim concerns after a reconsideration has been submitted.
- Delegated Credentialing: Execute a delegated agreement with Sunshine Health.
- Provider Demographic Updates: Update your organization's demographic information.
- Provider Enrollment Requests: Add a new practitioner or facility to your contract.
Questions?
Sunshine Health has a wealth of resources available to help answer your questions and address your concerns:
- Provider Support: Finding the Right Contact
- Provider Services: Call 1-844-477-8313
- Secure Provider Portal: Visit the Secure Provider Portal to check member eligibility, submit claims and more.
- Provider Engagement: Use the Find Your Account Manager tool to find the Provider Engagement Account Manager (PEAM) supporting your specialty and region.
- Claim Concerns: Resolve outstanding claims using the Claim Concerns form.
- Provider News: Bookmark Provider News to keep up with the latest updates.
- Provider Newsflash: Subscribe to our e-newsletter to get regular updates.
- Provider Resources: Visit Manuals, Forms and Resources to find provider manuals, important forms, scheduling standards and other resources.
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