Denial reason group 3
Your insurance company has denied your claim for the following reasons:
- Lack of authorization or pre-certification prior to services
- Lack of referral authorization
- Authorization number is missing or invalid
Steps you should follow to appeal insurance denials:
- Did you receive authorization prior to services?
- If yes, contact your insurance company and discuss why the charges were denied and ask that they be reprocessed.
- If no,
- Log on to Mayo Clinic patient online services.
- Select the Medical Record and Results menu.
- Print the required medical records pertaining to the denied charge.
- Print the supporting doctor's notes prior to and after the procedure, indicating why the denied service was ordered and what the results were.
- Make copies of all documentation for your own records.
- Complete and print the appeal form (PDF) and send via certified mail to your insurance company with the above supporting documentation and a copy of your EOB showing the denied charges.
- Did you obtain a referral authorization from your primary care physician?
- If yes, contact your insurance company and discuss why the charges were denied and ask that they be reprocessed.
- If no, contact your primary care physician and request that he or she provide a referral authorization to your insurance company.
- May 21, 2016
ART-20203441