It is an unfortunate reality that not every medication authorization request is approved and not every claim is paid as expected. Access 360TM can review a denial and help you navigate the situation. If a patient or prescriber decides to appeal an insurance company's denial, Access 360 can support first level and second level appeals with the insurance provider and Expedited External Review with an Independent Review Organization, which can be pursued concurrently. This support may include:

  • Denial review in order to identify appeal options
  • Denial research to provide you with step-by-step instructions for appeal processes, requirements and contact information for the appeals department
  • Provide an appeal template letter to assist with appeal verbiage and for you to modify as appropriate for your patient
  • Follow up with the insurance company or Independent Review Organization to ensure timely appeal determination