The below appeal sample letter for appealing against timely filing limit denial, we need to submit this letter with claim submission proof.

Practice name
Address
Phone#
________________________________________________________________________

11th September 2009

To

The Claims Adjudicators

UNIVERSAL HEALTHCARE
P O BOX 294
ST PETERSBURG, FL-33731
Dear Sir / Madam

Sub.: Appeal of Medical claims pertaining to Dates of Service 11/26/2008 ……………………

We had already submitted claims to you for the patients (Patient names) but the claims has been denies for lapse in timely filing limit. But as per our records the claims had been submitted within the timely filing limit deadline and we have attached all the details herewith. We are having all these accounts sitting in our books as outstanding for no fault of ours.

In this context, we request you to kindly have these claims re-processed and expedite reimbursements on these claims. Also we would be left out with no other option except to go ahead and bill the patients for these if we do not hear back from you.

If you have any clarifications on this, please feel free to call us at (phone number)

Hoping to hear from you soon in this context.

Thanks and Regards

Your name

Accounts Receivable – Reimbursement Specialist

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