Wig Medical

How Private Insurance Differs from Medicare and Medicaid

Plan Types That Affect Your Claims

How to Verify Coverage Before You Start

Coverage Verification Form

Reading and Interpreting a Benefits Summary

Building Your Insurer Reference Sheet

Insurer Reference Sheet

Anatomy of a Winning Claim

Pre-Submission Checklist

Writing Letters of Medical Necessity That Get Approved

Letter of Medical Necessity Template

Getting the Right Prescription

Sample Prescription

Prior Authorization — When It's Required and How to Get It

Documenting the Consultation and Fitting

Photo Consent Form

Consultation & Fitting Documentation Template

Filing with Blue Cross Blue Shield (BCBS)

Filing with UnitedHealthcare (UHC)

Filing with Aetna

Filing with Cigna / Evernorth

Filing with Humana, Kaiser, and Other Major Carriers

Reading an Explanation of Benefits (EOB)

Common Denial Codes and What They Really Mean

EOB Code Reference Guide

Underpayments and How to Catch Them

Coordination of Benefits — When Your Client Has Multiple Plans

Patient Responsibility Conversations

Financial Agreement Template

Why Claims Get Denied (And How to Prevent It)

Denial Prevention Checklist

The First-Level Appeal — Writing a Winning Response

First-Level Appeal Letter Template

The Second-Level Appeal and External Review

Second-Level Appeal Letter Template

Peer-to-Peer Reviews — What They Are and How to Prepare

Real Denial Scenarios and How They Were Overturned

In-Network vs. Out-of-Network — The Financial Reality

Superbills for Out-of-Network Reimbursement

Out-of-Network Superbill Template

Submitting Claims as an Out-of-Network Provider

Assignment of Benefits Form

Negotiating Single-Case Agreements

Deciding When to Go In-Network