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Sample
Letters of Appeal |
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Administrative
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Generic Appeal
- Inadvertent
coding error by practice
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Claims underpayment
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Lack of Recognition of CPT modifier 25
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Lack of Recognition of CPT modifier 59
Medical
Necessity
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Pre-Appeal requesting add’t information
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Letter to Health Plan-Option A
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Letter to Health Plan-Option B
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Letter to Health Plan-Option C
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Patient Letter Notification of Appeal
Prompt
Payment
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Letter to Health Plan regarding late payment
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Letter to State insurance commissioner or other
entity that regulates health payers
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Letter to patient’s employer or health
plan
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Letter to Health Plan regarding late payment
of claims in violation of the practice’s
contract
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