INSUPPORT® can provide information on PERSERIS billing and drug coding for claims submissions to the patient's insurance provider.
Addressing claim denials
A: Identify the reason for the claim denial
If your claim is denied by the patient's insurance provider, you will be notified of the denial reason by the insurance provider.
Some of the common reasons for denial include:
- Incomplete or inaccurate information
- Lack of prior authorization
- Diagnosis and procedure coding errors and omissions
- Insufficient medical necessity
B: Fix any errors and provide additional documentation
For patients enrolled in "Benefit Summary Information" with INSUPPORT®, INSUPPORT® can provide you with the requirements for claim resubmission as communicated by the patient's insurance provider. In addition to a completed enrollment form, INSUPPORT® requires a copy of the denial correspondence, original claim form(s), and Explanation of Benefits from the patient’s insurance provider in order to initiate the request for appeal information on the denied claim. This required documentation may be submitted via fax.
View Sample Letter of Medical Necessity
Receive information from a local Field Reimbursement Specialist (FRS) regarding your access and reimbursement questions.
Do I need to complete the INSUPPORT® Patient Enrollment Form to receive appeals information for a previously enrolled patient?
If the patient is already enrolled in INSUPPORT®, another patient enrollment form is not required to request assistance with researching a claim denial, however to initiate a review and research of a patient's denied claim, please provide the Explanation of Benefits and a copy of the denial correspondence from the patient's insurance provider. If the patient was not previously enrolled with INSUPPORT®, if the patient was not previously enrolled in INSUPPORT®, you may enroll the patient in "Benefit Coverage Information" to receive appeals information.