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7.3.1.2 Disallowed Electronic Appeals
The following claims may not be appealed electronically, and providers must appeal these denials on paper:
• Claims that require supporting documentation (e.g., operative report, medical records)
•Claims listed as pending or in process with explanation of pending status (EOPS) messages
•Claims denied as past filing deadline, except when retroactive eligibility deadlines apply
•Claims denied as past the payment deadline
•Inpatient Hospital claims that require supporting documentation
•Third-party resource (TPR) and other insurance
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