Provider Disputes/Appeals

The goal of Riverside Medical Clinic (RMC) is to provide our contracted providers, physicians and other affiliated groups with information needed to assist them with the Provider Dispute Resolution Process in accordance with Title 28 CCR Section 1300.71, or AB1455. Should you disagree with a decision made by RMC regarding the payment or denial of a claim, or RMC's request for reimbursment of an overpayment, please go to one of the following links for direction*:
 
How to file a provider dispute

General Claim Billing Requirements

Provider Dispute Forms

Claims Resubmission Form  (to be used only for submitting previously requested documentation)

National Provider Identification (NPI) Fax Form  This form is to be used when the provider has not supplied RMC with their NPI number. If you have not, please fill this form out and fax back to our contracting department at the number listed on the form.

If you are a contracted provider of Riverside Medical Clinic, you may request to access your claims information by faxing the form below* to: (951) 274-0321.

Request for a Provider Account and Password

Once the form is received, RMC will provide a username and password so that you may access a secure site housing specific claims received from your office, as well as claims that have been processed and closed. Once the form has been received, a letter will be mailed to you containing your password and instructions for logging on to your site.

Contracted Provider Reimbursement Information

You may also contact one of our customer service representatives at (951) 782-3060 and they will be happy to walk you through the process.

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