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APPEALING DENIALS
The process of responding to and overturning denials is streamlined by
the integrated database of over 1500 professionally written appeal
letters. Choose a letter from the templates available supporting
your position on the denial issue. A letter, complete with patient
and health plan demographic data, is then generated. All you need
to do is print, sign and send it.
• Cite Timely Payment Statutes to prompt
immediate action by the carriers which are unnecessarily delaying
payment.
• Cite medical necessity and preexisting statutes and case law.
• Collect benefits promised during the verification of benefits.
• Appeal coverage terminations with COBRA legislation.
• Appeal self-funded denials with ERISA statutory and case citations.
• Expedite and appeal precertification determinations with utilization
review laws.
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