Appealing denied claims

The Affordable Care Act grants the right to ask insurers to reconsider a denied claim or to appeal their decision. Make sure to take these important steps before beginning a formal appeals process:

Appeals checklist

You may need to include certain forms and documents in an appeals package if an insurer denies treatment to your patient

Please review each denial and the insurer’s guidelines to determine what to include in your patient’s appeals package

If the patient’s insurer has not responded within 30 to 60 days of receipt of the appeals package, contact the insurer to find out its status

Call HEPLISAV-B Access Navigator™* at 1-84-HEPLISAV (1-844-375-4728) for coverage and reimbursement support 8 am to 8 pm, ET, Monday through Friday

*While many health insurance plans provide coverage for HEPLISAV-B, the type and level of coverage can vary. Any information provided by a HEPLISAV-B Access Navigator is intended as a guideline only, and is not a guarantee of coverage. All claims are subject to individual plan coverage, guidelines, and submission of the actual claim. Coverage and reimbursement amounts are specific to the individual plan that a member or their employee has purchased, as well as the negotiated contract for each provider. Each plan decides its own reimbursement rate, which varies based on plan and patient group. Dynavax suggests that you contact the individual plan to determine reimbursement.

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