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The 1000 Page Appeal Letter:  Covering the Clinical Bases In Experimental/Investigational Appeals

When Attorney Jennifer Jaff appeals denied insurance claims, she uses boxes, not envelopes, for sending her appeals.

Her average appeal often consumes more than 50 record-gathering, research and development hours.  When ready for the box, some appeals can cover more than 1,000 pages.

"If I send in a 1,000 page appeal and I get a denial within ten days, I know they didn't read it. That can be very frustrating. What you need to do then is file the second level of appeal and then, if you have what's called an external appeal opportunity, that's where you're really going to get your best chance of winning," Jaff said.

Jaff's commitment to winning appeals is personal.  Jaff's successful, demanding career as a trial lawyer was interrupted in 2002 by a debilitating episode of Crohn's disease. . . .

Continue reading this article at AppealLettersOnline.com

Listen to the full Appeal Solutions interview with Attorney Jennifer Jaff via the Online Podcast.

AppealLettersOnline Featured Letters

Appeal Solutions added a number of letters for appealing gastroenterology denials.  Please see the following letters under the topic Specialty Care:

• Request for Clinical Criteria - Gastroenterology (New)
• Request for Coding Credentials - Gastroenterology (New)
• Request for Gastroenterology Peer Review (New)
• Request for Coding Criteria - Gastroenterology (New)

Access these appeal letters at AppealLettersOnline.com

50 State-Specific Appeal Letters And How To Use Them Like a Pro

We have developed an appeals training program specific to each individual state.  50 State-specific Appeal Letters & How to Use Them Like A Pro is a three hour presentation specific to state insurance claim review laws.  Tammy Tipton, President of Appeal Solutions, will discuss how to assert your rights when insurers deny or underpay medical claims.  Level I and Level II appeal responses will be discussed and legal protections related to appeal review will be explained.  Some of the appeal letters to be discussed include the following:

• Incorrect verification of benefits
• State and/or federal laws related to access to care, benefit calculation disclosure, direct access and clinical trial coverage and how to demand compliance with mandatory coverage laws.
• Coding appeals and demanding a review by a credentialed coder and release of coding criteria.
• Seven tips to improve medical necessity denials by using state utilization review laws.
• Getting action on unnecessarily stalled claims.
• Maximum Benefit Appeals and
• How To Respond to Refund/Recoupment Response letters.

Cost of the presentation is $2500 plus airfare, hotel and transportation expenses for your area.  Training includes 50 appeal letters customized for your organization's specific denial issues.

AppealLettersOnline.com Podcast

AppealLettersOnline.com has a unique opportunity for healthcare experts. We are seeking legal and revenue cycle experts interested in being featured in the AppealLettersOnline Podcast Library.

Participation is easy and cost free.  It allows you to talk directly with our healthcare clients about your area of expertise. We will interview experts regarding a number of hot topics.  The interview will be via phone and then podcast to more than 5,000 AppealLettersOnline.com members and visitors.

Your podcast will appear along with our currently featured podcasts:

• Jennifer Jaff, Attorney, on 1,000 Page Appeal Letters and Overturning Experimental/Investigational Denials and

• D. Brian Hufford, Attorney, on Post-Payment Audits and ERISA: Know Your ERISA Rights When Money is Demanded.  

If interested, email Tammy Tipton at t.tipton@appealsolutions.com with your suggested Podcast content.