Claims management letters/templates

Administrative

Generic appeal letter (Word, 27KB)

Inadvertent coding error by physician practice letter (Word, 28KB)

Claims underpayment letter (Word, 32KB)

Lack of recognition of CPT modifier 25 letter (Word, 32KB)

Lack of recognition of CPT modifier 59 letter (Word, 31KB)

Inappropriate E/M downcoding (Word, 35KB)

PPO discount taken when a contract does not exist (Word, 34KB)

Medical necessity

Pre-appeal letter requesting additional information (PDF, 19KB)

Medical necessity denial - Option A (Word, 28KB)

Medical necessity denial - Option B (Word, 28KB)

Patient letter notification of appeal (Word, 28KB)

Prompt payment

Letter to health insurer regarding late payment (Word, 28KB)

Letter to state insurance commissioner on other entity that regulates various health insurers regarding late payment  (Word, 29KB)

Letter to patient's employer or health plan sponsor regarding late payment  (Word, 28KB)

Letter to health insurer regarding late payment of claims in violation of practice's contract  (Word, 28KB)