Just because your iontophoresis insurance claim was denied doesn’t mean it’s the end of the road. By personally writing and submitting an appeal letter to your insurance carrier, you may be able to get that decision overturned.
This article will help you craft a clear and concise counter-argument for your appeal letter.
Basic Info You’ll Need
Before we get into the “why” of your appeal, let’s look at the basic info you’ll need to include at the start of your letter.
- Patient name, policy number, and policyholder name
- Accurate contact information for patient and policyholder
- Date of denial letter, specifics on what was denied, and cited reason for denial
- Doctor or medical provider’s name and contact information
Insurance carriers often look for specific verbiage when it comes to claims and doctors clinicals. In the opening paragraph of your appeal letter, outline the ways in which hyperhidrosis has affected your daily life.
For example, do you have difficulty:
- Getting dressed
- Preparing food
- Showering or grooming
- Driving due to a slippery steering wheel
Career & Employment
Is your excessive sweating impeding your career growth? Having difficulty finding a job? In the next paragraph of your appeal letter, list ways in which hyperhidrosis has affected your career or employment status.
For example, does your job require you to:
- Handle materials and/or products on a line
- Shake hands with prospects and customers
- Fill out a lot of paperwork
Other Treatment Options
When iontophoresis isn’t covered by your insurance plan, carriers often look to see if you’ve attempted other treatment options in the past. Use the third paragraph of your appeal letter to detail products/solutions you’ve tried and failed to see results with.
For example, have you been prescribed:
Cost & Inconvenience
When you’re forced to try alternative hyperhidrosis treatment options, those costs add up – and quickly. From monthly co-pays to trips to the pharmacy, use the next paragraph of your appeal letter to cite any recurring costs or time commitments.
For example, if you have to:
- Buy new clothes or electronics because you ruin them
- Cover a monthly co-pay
- Drop-off your RX at the pharmacy
- See a psychiatric professional
Perhaps the greatest toll hyperhidrosis takes on a person’s life is emotional. Closeout your appeal letter by speaking from the heart. Talk openly about your emotional struggles or the mental duress associated with hyperhidrosis.
For example, if you have trouble:
- Making friends
- Forming intimate relationships
- Playing sports that once made you happy
Submitting Your Appeal Letter
If you submit your appeal letter to your insurance carrier by fax, keep a copy of the transmission confirmation. If you submit by mail, send the letter via certified mail with a request of a return receipt.
Finally, organize all submitted materials, your appeal letter, receipts, and records of correspondence in a safe place should you need to reference them again. On average, most patients who appeal directly to their insurance carrier receive an official notice within 7-10 days that the appeal has been received. If you do not receive confirmation, contact your carrier to make sure your appeal is showing up in their system.
Need additional help navigating the insurance process? Contact our Treatment Specialists to review your symptoms, benefits, and eligibility today.