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| Appeals | Checklist |
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Although each payor and patient case may require different information, this checklist of forms and documents may help you determine what to include in your patient’s appeal.
 Appeal letter (see Forms and Documents for sample letter)
Denial documentation
- Explanation of Benefits (EOB)
- Denial letter
Medical documentation
- Initial history and physical
- Pathology reports
- Records of prior treatments
- Physician and clinic notes
- Imaging studies
- Infusion records
- Relevant labs
Other documentation such as journal articles and abstracts may be helpful with your appeal.
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