Wiki Appeals

[Bon2022]

Hello,

Any recommendations on what else can be done after I have sent two appeals to a particular worker compensation carrier and not wanting to pay accordingly for ambulatory services.

 

[Tourist95]

Certified mail requiring a signature on the next appeal. List all the dates, times, etc you have contacted them, spoke to them, left voicemails etc. Certified mail is the best way to say, you have received it and need to review it!

 

[cpclori]

Verify you are sending to the correct appeals address. Try calling and requesting to speak with manager/supervisor of claims division, not just a CSR

 

[haraml7]

Remember workers compensation have different rules and policies. You will have to go by what they pay or don't pay. They don't follow medicare guidelines. I would get more information as to why they are not paying it, where can you find their policies and procedures for this type of rendered service.