If your claim is denied, review the payer-provided Explanation of Benefits (EOB) detailing the reason for denial. Common reasons for claim denial or underpayment include:

• Lack of details on the patient’s history and clinical course
• Incorrect billing codes or omission of modifiers
• Incomplete documentation supporting the medical necessity and/or codes used
• Inaccurate description of services provided

To appeal a denial:

1. Review the rationale for denial and discuss it with the payer.
2. If there are no submission errors or the claim was denied because the payer was not convinced UDENYCA^® was necessary, submit additional documentation to justify the medical necessity of UDENYCA^®. Download a Sample Letter of Appeal , UDENYCA^® Prescribing Information , and the UDENYCA^® FDA Approval Letter .
3. If there are no submission errors or the claim was denied because the payer was not convinced TORELBY™ was necessary, submit additional documentation to justify the medical necessity of TORELBY™. Download a Sample Letter of Appeal , TORELBY™ Prescribing Information , and the TORELBY™ FDA Approval Letter .