Problem: Your claims are being denied despite the fact that a verification of benefits and/or a pre-authorization of care was obtained prior to extending treatment.

Solution: Cite relevant court rulings informing insurers they can be liable for misrepresentations made during verification and utilization review.

Problem: Insurance carriers are frequently failing to pay your claims promptly.

Solution: Use our appeal letter to put ERISA claims processors on notice that lengthy claim reviews are no longer legal.

Problem: Your claims are being paid at reduced rates according to the insurance company's determination of usual and customary rates.

Solution: Cite relevant state and federal disclosure laws requiring insurers and administrators to advise beneficiaries and healthcare providers as to how the reimbursement rate is determined.

Power of Appeals is a Denial Management software application that improves cash flow and reduces write-offs by analyzing denials, streamlining denial appeals, tracking the disposition of denial appeals and providing denial prevention reporting and analysis.  Find out more by downloading the brochure.

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