A Physicians Practice report discusses five points on addressing and resolving medical practice eligibility issues with payors.
- Obtain the original insurance verification completed by office staff.
- Write a letter of appeal that includes the payor representative's name, the date and time, and the name of the front office staff member.
- Retrieve facts surrounding the patient's visit, how complicated the case was and any tests ordered.
- Explain how the practice is saving the payor money, such as by sending the patient to physical therapy or designing a home exercise program.
- Summarize what is being asked for, such as six outstanding claims that must be paid in full by the payor and why.