The first call to place is to the MCO's claims department and, if
necessary, request to speak to a supervisor. If you do not get a satisfactory
answer or resolution, then call the MCO's provider service line. Many members
are frustrated by the "service" available through this line. The
waits may be lengthy, and the service representatives sometimes don't seem to
understand the issues. If the representative is unable to provide you with the
necessary information for resolving your payment issue, ask to be transferred
to a supervisor, just as you may have done when you called the claims
department. (Try to stay on the line, even if the wait for the transfer seems
lengthy; otherwise, you'll wind up having to begin the process again.) If the
representative refuses to let you speak with a supervisor, or if you speak
with the supervisor and still run into a brick wall, go on to step 3.