What this covers
Preparation and submission of one administrative appeal level, including document organization, deadline tracking, and submission support.
Included
- Review denial letter and policy
- Organize supporting documents
- Draft appeal letter based on facts provided
- Track deadlines and submission
Not included
- Legal representation or legal advice
- Guaranteeing overturn
- External review or litigation support
Deliverables
- Organized appeal packet
- Appeal letter draft
- Deadline tracker
Requirements
- Signed service agreement
- Denial letter
- Medical records
- Plan documents
This service provides administrative, informational, organizational, navigation, communication, research and advocacy support. It is not diagnosis, treatment, prescribing, medical decision making, nursing, legal representation, legal advice, insurance sales or brokerage, or emergency care.
Case review required
Duration
Up to 21 days per appeal level
Contacts
5
Revisions
1
Mode
Request
If the appeal is denied and a higher level or external review is needed, a new Statement of Work is required.