Wiki Medicare Appeals

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suemt

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I know this isn't quite the right place for this, but this group seems to be so helpful I thought it was worth asking.

Does anyone know a good source for locating sample appeal letters to be submitted to Medicare?

Thanks in advance for any assistance.

Sue
 
Thanks, mjones. We have the appeal forms, but due to the nature of the situation we need to submit a compelling letter of explanation to accompany the forms.
 
Appeal Letters

Hello,

Does anyone have a sample appeal letter to submit to medicare or one that I can use for all appeals?

Roseann
 
Sample letter

The simpler, the better.

MEDICARE OFFICE ADDRESS

Re: patient / subscriber # / DOBirth

Dear Sirs,
We are appealing denial of the following service, which has been erroneously denied as (reason for denial):
DOS / CPT code / Description

(Paragraph explaining circumstances ... cite CPT and/or CCI edits as appropriate)

I enclose copies of the medical record. Please reconsider payment for this medically necessary service.

If you have any questions, please do not hesitate to contact me at (phone #)

Sincerely,
Name, CPC
Title

Hope that helps.

F Tessa Bartels, CPC, CEMC
 
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