Reviewing DX with PCP which was denied for pre - exisiting

Practice address

Phone# 407-123-45678
______________________________________________________________________________________
05/28/2010
Dr.
Attn: Ayse
Address here
FL 33713-8723
Re: Request to re-view the diagnosis codes whether falls under pre-existing period.

Patient Name :
Primary Carrier : BCBS
Health Insurer Identification Number : HOSPH41862466

Dear Sir/Madam:
This is to bring to your kind attention that BCBS denied the above mentioned patient’s claims for pre-existing condition information hence we would like to request you to review the diagnosis codes mentioned below in order to determine if any of these codes fall under the waiting period.
The diagnoses are:
491.20, 518.82, 786.52, 511.9, 486, 510.9, 496, 510.9, 786.09, and 780.53……..
Thank you for reviewing and assisting us in reversal of this claim denial. If you require any
additional Information, please contact me at 407-745-1849 between the hours of 8:00 a.m and 5:00 p.m.

Sincerely,
Henry Samuel
(Account Receivable – Reimbursement Specialist)