Health Symphony Message Board of Submitted Health Insurance Questions


Question

Response

Appeal Letter to Use

"I don't have health insurance, but my physician charged such as high rate for my visit." "For people that don't have health insurance, don't pay full price, always ask for a discount."

Cash Pay Negotiations Appeal Letter

"I gave the hospital my insurance information, but they billed with my old insurance instead and now when they submitted to the correct insurance plan, it was denied for not being timely." "If the hospital made an error, and especially if it is an in-network facility, the health plan should take this into consideration and reconsider the claim."

Untimely Filing Appeal Letter

"I would like to get approved for Gastric Bypass surgery" "A statement of why the surgery is needed to resolve a health condition along with a statement of medical necessity is needed."

Surgical Weight Related Appeal Letter

"My health plan reduced the amount paid due to usual and customary and now I am responsible for the difference." "A health plan needs to pay an appropriate amount, based on the geographical area where the service was provided."

Usual and Customary Appeal Letter

"My physician was on vacation and the physician who took his place was not part of my network." "If you we were referred to an out of network physician by an in-network physician, a request should be made to the health plan to consider this as an in-network claim."

Non Participating Appeal Letter

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