The other day, I called one of the managed care payors to get an update on an appeal that had been submitted two months ago. Surely, given the length of time that had elapsed, a resolution was imminent. After enduring a forty-five minute hold time and then requiring a transfer to a higher level representative, I was advised that the “appeal” had not been reviewed because they did not know it was an appeal. I questioned how it was possible that an appeal sent to the appeals department at the dedicated appeals address could be confused with anything other than that. The supervisor read through the document and stated that it wasnt clear to them that it was an appeal even though the first line clearly read “we are appealing”. She told me that it could have been a request for reconsideration. Ill leave my candid response to her to your imagination.
