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Workers’ compensation claim was in a hearing status for 5 months until finally disallowed in March 2018. Billed patient’s commercial insurance and followed up weekly on status. Denied by health insurance for no authorization for inpatient stay and appealed with the needed workers’ compensation documentation. Appeal was denied as not medically necessary in May 2018.
$50,000 – 100,000
The Argos claim representative reviewed all the medical information for the inpatient stay and determined we could appeal the denial. We prepared a formal appeal letter and included all pertinent medical documentation, including nurse’s notes. Bill was paid in July 2018 leaving less than $100 in patient responsibility.