Appeal

When a claim or prior authorization is denied, providers have the right to appeal the decision. Appeals must include supporting clinical documentation, relevant CPT/ICD-10 codes, and a clear justification for medical necessity. PRACTIS auto-generates appeal letters with AI-drafted clinical justifications, increasing appeal success rates by 67%. Most payers allow 2-3 levels of appeal, with strict deadlines (typically 30-180 days from denial).