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Appealing Coordination of Benefits Stalls And Denials
Denials and refund requests related
to COB appear to be growing. COB investigation
stalling on the part of the insurance carrier can frequently
be resolved with a letter demanding compliance with state
COB regulations. The majority of states have adopted the
National Association of Insurance Commissions model COB
provision. Click here for details on what this means for your facility. |
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AppealLettersOnline Featured Letters:
AppealLettersOnline.com has added a number of new coordination of benefits appeal
letters to assist users with demanding a prompt resolution
to COB investigations. See the AppealLettersOnline.com repository Topic: Stalled
claims, Subcategory: Coordination of Benefits for the following letters:
Request for COB/SOB Clause – This
letter is designed to seek disclosure of the Coordination of
Benefits exclusion and insure that the carrier is abiding
their own written terms regarding coordination.
Request for Primary Carrier to
Recognize Authorization – This letter is designed to appeal
carrier denials for failure to preauthorization when prior
approval was not obtained due to the insured’s failure to
provide complete insurance information regarding both
policies.
State-specific COB appeal letters – These letters cite state
mandates and insurance regulations regarding conducting COB
investigations and making COB determinations in a prompt
manner.
Sign up at
AppealLettersOnline.com to access these new appeal letters.
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Request A Copy of Your State’s Coordination of Benefits Regulation from Appeal Solutions
Most state’s COB regulations are available online. If
you are seeking compliance with the regulation, download a copy of the
regulation, highlight the particular provision which applies to your appeal and
attach it to your appeal letter. Email t.tipton@appealsolutions.com
if you would like to request the link to your state’s regulation. A brief
explanation regarding your office's difficulties related to coordination of
benefits would also be appreciated.
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