Evaluate the AWP Price of a Drug Appeal Letter Free Download


Evaluate the AWP Price of a Drug

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Appeal Letter Displayed for Your Convenience


Health Symphony Appeal Letter

to Evaluate the AWP Price of a Drug

Your name and address

Date

Address of Claims review department


RE: Name of Insured:
Plan ID #:
Claim #:

Dear Claims Review Department:

[Health Plan] has recently paid considerably lower for a pharmaceutical drug than what is normally paid for by other health plans. Please find enclosed a copy from the Redbook, the most recent Average Wholesale Price (AWP) information regarding this drug. The AWP (average wholesale price) is a commonly utilized standard to determine the reimbursement of these types of claims.

Please use this information to properly reimburse for this claim and to update your records. Please feel free to contact me at [phone number ] or my physician at [phone number] if you have any questions.

Thank you for your time and consideration.

Sincerely,

[Insured’ name]

Enclosures

The AWP by the Redbook, or similar resource, of the specific drug being appealed