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How-to · Health care

Appeal a Trillium denial and ask for a state hearing

If Trillium denies, reduces or stops a covered service, you can appeal to Trillium within 60 days, then ask OHA for a hearing within 120 days.

Steps

5 steps
  1. Find your denial letterTrillium sends a denial letter (Notice of Adverse Benefit Determination). If you did not get one, you can ask Trillium for it.
  2. Ask Trillium for an appeal within 60 daysCall, or send the Request to Review a Health Care Decision form. The 60 days count from the date on the denial letter.
  3. Mail a written request if you preferYou can mail the form or a written request to Trillium's appeals address in Eugene. Follow the instructions on your notice.
  4. Wait for the appeal decisionTrillium has 16 days to reply and can take up to 14 more. You then get a Notice of Appeal Resolution.
  5. Ask OHA for a hearing if you disagreeUse OHA's online hearing form or a request form. You have 120 days from the date on the appeal decision.

Bring

  • Your denial letter
  • Written OK if your provider files
To keep getting a service during an appeal or hearing, ask within 10 days of the notice's effective date.

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