American College of Cardiology

Administrative

• Generic Appeal
• Inadvertent coding error by practice
• Claims underpayment
• Lack of Recognition of CPT modifier 25
• Lack of Recognition of CPT modifier 59

Medical Necessity

• Pre-Appeal requesting add’t information
• Letter to Health Plan-Option A
• Letter to Health Plan-Option B
• Letter to Health Plan-Option C
• Patient Letter Notification of Appeal

Prompt Payment

• Letter to Health Plan regarding late payment
• Letter to State insurance commissioner or other entity that regulates health payers
• Letter to patient’s employer or health plan
• Letter to Health Plan regarding late payment of claims in violation of the practice’s contract