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Wiki Appeal Letter

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hallm42

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Does anyone have a great insurance appeal letter they use for bi-lateral breast reconstruction when insurance companies decide not to pay accordingly to guidelines?

If so please e-mail me to margaret@synergyplasticsurgery.com

Thank you so very much!
 
Short, Sweet, Specific

Dear Insurance

RE: patient, DOB, subscriber #, Group #, Claim #

We are appealing level of payment for DOS / CPT / Description

This procedure was performed bilaterally, and we appended the appropriate modifier(s).

I enclose a copy of the operative report for your convenience. Please reconsider level of payment.

Sincerely,

Name, CPC
Title


Hope that helps.

F Tessa Bartels, CPC, CEMC
 
One more thing

Oh, I also clearly underline the appropriate areas in the op report that show right and left ... frequently using two colors of ink (for example red for Left, blue for Right)

F Tessa Bartels, CPC, CEMC
 
Appeal Letter for procedure

Hi does any one know how can to write appeal letter denial for procedure because didn't obtain prior authorization for procedure, please any one advise, thanks Ana
 
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