Once the insurance has informed us the request has been denied, first it will be evaluated for correctness and appeal. If the denial seems correct, based on the available information, and does not have a very high likelihood of being overturned on appeal it will be marked as denied and enter this status.
A copy of the denial will be attached (if available) with a short write up on what would be needed for approval. From here the request can be:
- Appealed
- Closed
- If no action is taken the request will close automatically after 5 days.
Appeal
If an appeal is requested by the provider or patient you can select the "Appeal" option. It will ask if it is a provider or patient requested appeal. Please comment any additional information regarding the appeal request.
Close
If no appeal is to be requested, the request can be closed by selecting the "Close" option. This will most the case from "Open" to "Closed"
