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The Appeal Letter

Combat Denied Claims & Get Paid What You Deserve!

How Do Mental Health Parity Laws Impact “Usual, Customary and Reasonable”

Usual, Customary and Reasonable Benefit Adjustments are often ambiguously applied to out-of-network claims and providers are left with little understanding of if the benefit calculation is accurate or not.

While these balances are often the patient's responsibility, many healthcare providers take on the advocacy role by seeking clarification regarding the UCR calculation, appealing excessively large discounts and seeking input on what pricing database was used to calculate the benefit.  Read More. . . . Featured Letters

The appeal letter collection has two letters citing the Mental Health Parity and Addiction Equity Act (MHPAEA).

See the topic Specialty Care Appeal Review and the subtopic Mental/Nervous/Substance Abuse at for the following new letters:

  1. U.S. Mental Parity Lack of Auth
  2. U.S. Mental Parity UCR
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Medical Appeals & Denial Management Guru
Tammy Tipton Owner & Founder, Appeal

Appeal Solutions, Inc.