Writing an effective appeal letter to an insurance company can significantly, and positively, impact your revenue flow. Once you find that your claim has been denied and you have exhausted any reconsideration rights to dispute the denial reason, it is necessary to respond to the insurance company with a well written and persuasive appeal letter. Implement these steps to craft a successful letter and gain the maximum reimbursement due them.
A) Components to be included in the letter
B) Putting it all Together: Consider these factors before sealing the envelope or hitting the upload button. It is important to carefully review the information you have chosen to include. If it is not truly pertinent to the denied claim, remove it. The order you send documents in is key for the appeal department to understand the story you are creating. Be sure to call or review the payer policy online to have accurate information as to how they accept appeal letters, some of them prefer the submission to be online while others may only provide a specific mailing address. If a case or tracking number is issued, be sure to document it for your records and keep a hard copy for your records. Most importantly, revenue cycle professionals must have a way to track the appeal and follow up to ensure that the appeal was received and the claim was reprocessed for proper reimbursement. A spreadsheet can be a useful tool in managing the life of your appeal letters and claim denial resolution.
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