Claim Intake
By answering the following questions about your denial we'll help you determine your best path of recovery, whether that's an appeal or a required negotiation IDR process.
Your progress is saved locally so you can continue if you refresh.
Who are you starting this claim for?
We will tailor the next questions based on your role.
What do you need help with?
Choose the pathway that best fits your claim.
Is your plan through a government, church, or school group?
This affects which appeal pathway applies.
Which insurance company denied or underpaid the claim?
What type of provider was involved?
Do you know the network status for this provider?
Which state were you treated in?
When was the service or denial, and how much was denied?
You can find this on your Explanation of Benefits (EOB).
Use the denied amount listed on your EOB.
Are you still seeing this provider?
Where should we send updates?
Is the member part of a government, church, or school plan?
What type of provider are you billing for?
What is the provider's service type?
Who is the provider or facility?
Which insurance company denied or underpaid the claim?
What was the network status for the claim?
Who should we coordinate with?
What is your primary practice field?
What is your primary practice field?
Which state is the practice located in?
Which insurance company denied or underpaid the claim?
What was the network status for the claim?
When did you receive the denial?
Use the denial date from the EOB or payer notice.
Format: YYYY-MM-DD. Must be today or earlier.
What is the claim number?
What was the date of service?
You will find this on the EOB.
Which codes were billed?
CPT/HCPCS/Revenue codes help us negotiate accurately.
Did you receive an initial payment on this claim?
Amounts and denial context
Who should we coordinate with?
Review & Confirm
Confirm the details below before submitting.
We will use this information to prepare your appeal. You can go back to edit any answer.