| |
|
 |
|
The majority of the appeal letters can be used by any type of health care provider. We have many hospital and physician subscribers as well as ancillary and alternative/complementary care providers.
|
|
|
Yes. The terms of agreement allow the member to distribute the letters to other employees of the organization. However, only one person can be the member and access the material online. Further, distributing letters to anyone outside of the subscriber’s organization is prohibited by the terms of agreement.
|
|
|
The letters are categorized by denial type. We provide extensive information on what letters should be considered for each specific denial type and how to select the most appropriate letter.
|
|
|
No. We do not sell letters on an individual basis.
|
|
|
We receive a lot of positive feedback regarding our site’s effectiveness. Further, we have a high rate of membership renewals beyond the initial year. However, we are unable to calculate an all-around accurate success rate. A member’s success rate will typically vary depending on the denials chosen for appeals, the organization’s billing policies, documentation quality and persistence in filing multiple levels of appeal. We do guarantee that the information will make it easier to file appeals since access to up-to-date information and sample letters facilitate a prompt, thorough appeal.
|
|
|
No. AppealLettersOnline is an educational resource. We do not file or process appeals for patients, medical billers or insurance carriers. Some insurance carrier have online complaint and appeal filing instructions. However, it is always a good idea to call and get the name of the appeal coordinator and send the appeal by certified mail to this person.
|
|
|
We do not allow cancellations prior to one complete year of membership. Once a membership is started, the member is granted unlimited access to the letters and a full year of membership is required.
|
|
|
|
| |
|
We have designed the web site to give visitors a very comprehensive look at the site materials. All letter titles can be viewed and a number of sample appeal letters downloaded so that potential subscribers can assess the quality of the content and determine if a membership would be advantageous.
|
| |
|
We typically update the site on a monthly basis with new letters and/or existing letter updates.
|
| |
|
Yes. We have a number of different letters to refund/recoupment responses which range from challenging untimely requests to seeking more detailed disclosure related to the reason for the action.
|
| |
|
Yes. We have a number of letters developed for prior authorization denials. Further, our medical necessity appeal letters can be very helpful if the denial is strictly clinical.
|
| |
|
Yes. We have a number of specialty-specific letters.
|
| |
|
Absolutely. Some of the sample letters may contain enough information to persaude the insurance carrier to reconsider. However, many types of denials, for example a medical necessity denial, will likely require some treatment-specific information to be effective. The appeal letters are meant to provide some various ideas on how to present information but are in no way exhaustive or complete. Users must use their judgement in deciding what information would be persausive on each appeal and include additional information accordingly.
|
| |
|
One of the most important aspects of appealing denied claim is to understand the laws that apply. Many group insurance policies are governed by ERISA and are exempt from state mandates. Other payors, such as Medicare and Medicaid, fall under a different set of claim processing regulations. It is beneficial to familairize yourself with the various types of potentially applicable laws and discuss which laws apply to which payors with your attorney. The U.S. Department of Labor, State Department of Insurance and other governmental web sites also often provide some education information regarding this issue.
|
| |
|
Members that also own a licensed copy of our Power of Appeals Denial Management Software are able to update their POA letter database from the letters in AppealLettersOnline.com's repository. This requires that you have a licensed copy of POA v5.5 or newer. Click here for more details.
|
|
|
|
|
|
|
|
|
|
Who Should Join
