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Review and Listing Dispute Request

Review and Listing Dispute Request

Insurers, government healthcare programs, claims administrators, and authorized representatives may use this private form to request a factual correction, review reconsideration, or review of a payer listing. This is an editorial request process, not an insurance appeal or government regulatory complaint.

What to include: Link to the affected review or listing, select the closest reason, and briefly identify the organization you represent, the specific factual issue, the correction or action requested, and any public source that supports your request. Leave contact information if a reply is needed. Do not include patient names, claims numbers, medical records, or other sensitive details.

Requests are received privately and reviewed on their merits. Submission does not automatically remove lawful criticism or accurate listings. Review may take up to 90 days; no resolution time is guaranteed. Read the checkbox agreement carefully before submitting.

Do not include names, medical records, diagnoses, claim numbers or identifying details. No login or email is required. This report is not posted publicly. Filing a report does not automatically remove a disputed review.

This box is not preselected. Checking it is mandatory: without it this complaint cannot be submitted. The agreement covers future related correspondence even if sent through another channel; other channels do not count as separate routine complaint submissions. Reports are received privately unless ELF lawfully selects portions for publication under its transparency policy.

Separate routes: For exposed patient information or urgent privacy/safety issues, use the private privacy/safety alert. Court papers, statutory copyright notices, and legally effective service of process follow Legal Notices & Formal Process and are not conditioned on this form. See the Terms of Use and Privacy Policy.