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New eNewsletter Format
Incase you haven't noticed, The Appeal Letter eNewsletter is
now being distributed in HTML format. If your e-mail
software doesn't support HTML e-mail, you should still be
receiving the eNewsletter in plain text format. |
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Successful
Rehab Appeals Depend on Medical Documentation
Denials for
rehabilitation claims based on lack of medical necessity can
be appealed and overturned...read
the entire article |
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Tips for Receiving Timely Decisions
from Insurance Carriers
If you are having trouble getting timely decisions from insurance
carriers, URAC now has online complaint filing. URAC has established standards for excellence in timely utilization
review and has a number of important protections for patients and physicians. Let them know if one of their
members is noncompliant with the standards. More information on using URAC in appeals is covered at www.AppealLettersOnline.com. |
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Denial Noncompliance by Health
Insurers
Have you noticed how many carriers are making denials purposely vague
and ambiguous to make it difficult to detect unfair denials? Don't accept unfair claim denials without a fight. If
you are looking for the appropriate response to unclear and ambiguous explanations of benefits, look to your state and ERISA disclosure laws. AppealLettersOnline.com has several appeal letters citing disclosure laws that can be used to
respond to poorly worded denials. |
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Refund Request Alert
Many medical billing offices are reporting an alarming number of refund
requests. These requests need to be reviewed very carefully for compliance with state laws which restrict insurance
carriers from retroactively denying precertifications. AppealLettersOnline.com provides extensive information
regarding this issue due to the confusion over what rights insurance companies have to ask for money back on paid
claims. |
