Michigan Medicaid Help Needed: How to Submit an Appeal Under MCL 550.1915

Hello everyone,

My denial letter says "Thus, Meridian is only required to provide those benefits required by its Medicaid agreement with the State of Michigan. One of the sources for those benefits is the Medicaid Provider Manual. In section 8 of that Manual (page 30), “Noncovered Services," it states that bite splints are not covered. In addition, the fee schedule notes for procedure code D9940 it is only a benefit for Children’s Special Health Care Services beneficiaries. Therefore, this device is not a covered benefit for the Petitioner under their dental coverage. This is a final decision of an administrative agency. Under MCL 550.1915, any person aggrieved by this order may seek judicial review no later than 60 days from the date of this order in the circuit court for the Michigan county where the covered person resides or in the circuit court of Ingham County".

I just need to know how to submit an appeal under MCL 550.1915. I searched online for hours, but unfortunately, I couldn't find any information. I have documents and evidence of how terrible bruxism affects my health, plus I have used nothing, 0 dollars of my annual maximum cost of dental benefit. The only device I need is the mouthguard.

I just need the form to appeal under MCL 550.1915. If anyone has any information regarding the form, I would greatly appreciate it.

submitted by /u/roozze1
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