Appeals Procedures  

• Accounts will be fully investigated and worked as new  

• A call will be made to the Insurance carrier to find out what is the final determination on pending claims.  

• A written appeal will be sent within 10 days with proper documentation attached for prompt resolution of claims. (We will need a copy of your contract with all carriers)  

• As per client request we will generate custom reports based on your needs. (See Sample Reports Attached)  

• All accounts will be worked to the fullest until closed.  

• We will partition a section of our web server to allow client access 24/7 and improve communications.  

• All adjustments or corrections of claims need to be approved by your management.  

Upon receipt of any payment or final determination from insurance carrier resulting to Self-pay accounts will be handled as follows:  

• Client Management will approve all accounts that are transferred to self-pay collections.  

• A first letter series will be sent to the patient explaining insurance determination and to respond within 30 days. The account shall be followed up within 15 days with a phone call. (See Sample Letters)  

If non-responsive at 30 days a 2^nd letter is generated explaining that the claim is being transferred to collections agency within 30 days