Letter of Appeal

[hockey]

Hello everyone!
I work in a Chiropractic office in California and today I get to write my first letter of appeal to ACN. My question is what do I say?
Thanks, Celine

[Pay_My_Claims]

well.........what are you appealing? What was the denial in regards to?

[PMRNC]

Dear Carrier.

This is an appeal, please pay our claim

Thank you


Seriously, you write your letter based on the reason you believe the claim needs to be paid/considered. If you need to attach supporting documentation you would do so.

No one here can give you anything other than what I wrote at the top because we don't even know what your appealing, why you are appealing, etc.

[hockey]

A claim that was denied.

[PMRNC]

A claim that was denied.

Tell me you are not the one doing the appeal?

Seriously, come on. If you want help you need to be MORE specific. 

[Pay_My_Claims]

Hockey,
Linda is correct. When doing an appeal you are showing just cause why they should have paid, or approved services. When you asked what to say, we can't answer that because we don't really know what is going on with that claim. It can be denied for various reasons.

Timely filing
no authorizations
no benefits
incorrect coding

If I had a claim to deny for timely filing, it will not be worded the same as the one for no authorization. I will address the situation as it pertains to the denial. Its like going to court. The plaintiff says you didn't file the claim in time (insurance company) you, (defendant) shows the judge (appeals dept) proof of timely filing. You state that in your claim  and then you pray!!