appeal

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    Wiki 28470 not preformed

    Provider billed 28470x2 diagnosis: M84.374A After appealing with chart notes, UHC says that the chart notes do not support that the 28470 was preformed. Dispensal of pneumatic cam walker was documented and diagnostics were preformed to accurately diagnose the fracture. All of this information...
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    • Thread
    • appeal denial fracture help ortho orthopedic podiatrist podiatry
    • Replies: 7
    • Forum: Orthopaedics
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    Wiki NJ Workers Comp Appeals

    As many of you know, many NJ Workers Comp insurers pay poorly. There is no fee schedule in place, which is a good thing...but, has anyone found a means of leveraging a higher reimbursement? Though we're sometimes successful by submitting redacted comparable EOBs to these payers, most of the...
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    Wiki Out of Network Appeals for ERISA plans

    Does anyone have an effective appeal letter which addresses inadequate reimbursement for OON self-funded plans? We have a solid assignment of benefits form, however, we could use some direction with the context of our actual appeal. I understand we have quite a bit of rights under ERISA. If...
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    Wiki Auth Appeal Letter

    Help! I am in need of a template or sample of an a letter appealling a denial for no authorization obtained.I have a denial from a carrier and am stumbling over exactly how to word this, so a sample, (all info redacted) would be soooo appreciated. Thanks!!:)
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    Wiki Need insight on Medicare Appeal

    I am having to appeal a claim for the first time with Medicare. I am not exactly sure where to begin. Do i need to send the appeal directly to Medicare or to our FI? Any other tips would be great. Thanks
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