Submitting an Appeal

If you believe a claim has been wrongfully denied, either fully or partly, you may submit a written appeal. You will have 180 days from receiving the denial notification to submit an initial appeal with us.

All appeals must include: 

1. The name of the member
2. The member’s social security number
3. The group name or identification number
4. A statement in clear and concise terms of the reason or reasons for disagreement with the handling of the claim
5. Any material or information that the member has which indicates that the member is entitled to benefits under the plan

To appeal a post-service claim, submit your appeal in writing to our appeals resolution team:

Sana Benefits
Attn: Appeals
P.O Box 660675 #35777
Dallas, TX 75266-0675

To appeal a pre-service claim, submit your appeal in writing to our utilization review administrator: 

Valenz
12802 Tampa Oak Boulevard
Suite 330
Tampa, FL 33637
Phone: 877-608-2200
Fax: 813-514-0607
Email: carecustomerservice@valenzhealth.com

Once your written appeal is received, it will be reviewed, and an initial determination will be sent to you within the following timelines:

Pre-service Claims: Within 30 days from receipt of appeal
Urgent Pre-service Claims: Within 72 hours from receipt of appeal
Post-service Claims: Within 60 days from receipt of appeal