Now is the Time to Expand Your
Verification of Benefits Form
Now is a good time to make sure your medical organization’s verification process is sufficiently thorough to
identify the effects of pay-the-patient initiatives, high deductibles and tighter utilization
review controls. . . .
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AppealLettersOnline Featured Letters
AppealLettersOnline.com has a number of appeal letters specifically designed for assisting with appeals
related to incorrect verification of benefits. See Benefit Disclosure at the AppealLettersOnline.com
website for information. New appeal letters to address orthopedic appeals have been added. See the following new
letters under Specialty Care:
Request for Clinical Criteria – Orthopedic
Request for Coding Credentials – Orthopedic
Request for Coding Criteria – Orthopedic
Request for Orthopedic Peer Review
We have also added a number of state-specific appeal letters for the states of Georgia and Kansas, including the following appeal letters:
50 Appeal Letters & How To Use Them Like A Pro
Appeal Solutions will present 50 appeal letters and discuss using them most effectively in an appeals audio conference set for March 10. Tammy Tipton, President of Appeal Solutions, will discuss how to assert your rights when insurers deny or underpay. Level I and Level II appeal responses will be discussed and legal protections related to appeal review will be explained including:
Utilization Review and demanding prompt response, peer review and release of clinical criteria to support denials.
State and/or federal laws related to specialty care including access to care, peer review, anti-discrimination, direct access and clinical trial coverage and how to demand compliance with mandatory coverage laws.
Coding appeals and demanding a review by a specialty care coder and release of coding criteria.
Seven tips to improve medical necessity denials.
Getting action on unnecessarily stalled claims.
Maximum Benefit Appeals and
How To Respond to Refund/Recoupment Response letters.