Medical Appeal Letter Sample


Medical Appeal Letter Sample. Enclosed are claims that were submitted to you, but have not been paid as of this date. The charges were rendered on [date of service] and totaled [claim dollar total]. [Health Plan] has denied payment on these charges because [Health Plan] has indicated that these claims were not processed due to their

Medical Appeal Letter Sample. failure to meet the applicable timely claim filing requirement.
Our physician's medical group has stated that they must follow the requirements of their Contract with [Health Plan]. In this case, it appears they did submit their charges to you within the time frame allowed. We have enclosed the electronic billing submission confirmation record as proof that the charges were billed on time.

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