Instructions: Please complete the assignment by reading

Instructions: Please complete the assignment by reading the scenario and composing the necessary letter according to the instructions, using Times New Roman, size 12 font and proper formatting for a full block style letter. You need to submit this sheet with the completed assignment. Task: You work with the insurance specialist in Dr. Wang’s practice. She is discussing a recent claim denial with you that she wants you to compose the appeal letter for. The patient had a diagnostic anoscopy in the office and that portion of the claim was denied for lack of medical necessity. The primary diagnosis that was submitted was rectal bleeding therefore medical necessity was established. Please read the details of the submitted claim and compose an appeal letter for this procedure, stating what medical necessity is and stating how it was established for the patient’s transmitted claim, using professional communication skills. The appeals letter must be addressed to the following: Ms. Jane Doe, Claims Examiner, Division of Appeals, Suite 333 Plaza Managed Care Plan 555 Independence Court New York, NY 10012 Compose a properly formatted, block style letter to the third party representative indicated above. This letter should address the denial, state what documentation is attached to support the appeal you are making for denial of this claim and be worded using professional language skills. The letter should be typed using Times New Roman, size 12 font. You need to include the patient information in the letter and the claim number. You should also send this letter from you with your contact information and your title for Dr. Wang’s practice. Patient Information: Kevin Smith Date of Service: 5/17/2020 1708 Bedford Avenue ICD-10: K62.5 Brooklyn, NY 11234 Denied Procedure: Diagnostic Anoscopy DOB: 2/11/65 CPT Code: 46600 Insurance: Plaza Managed Care Plan Reason for Denial: Lack of Medical Necessity ID#: 5600128/Group #: TLC5466 (Procedure not justified by diagnosis) Employer: Verizon Claim #: KS3400999 Date of Denial: 6/15/2020 Provider Information: Name: David Wang, MD Address: 255 Park Avenue, Suite 2D, New York, NY 10020 Telephone: 212-555-3212 EIN: 12-1233360 NPI: 3334090887 SCIENCE HEALTH SCIENCE NURSING MEDICAL AH154

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